MRI CERVICAL SPINE WITH AND WITHOUT CONTRAST:
CLINICAL HISTORY: 55 years of age, Female, concern for retropharyngeal and/or bony infection in setting of prior retropharyngeal phlegmon complicated by MSSA bacteremia. Evaluate for
osteomyelitis.
FINDINGS:
Alignment: Loss of the normal lordosis, likely degenerative.
Vertebrae: Ill-defined cortical erosive change of the dens and the anterior arch of C1, better demonstrated on prior CT neck. A small amount of fluid is seen within the atlantodental interval, likely corresponding to mild widening of the atlantodental interval better seen on prior CT neck.
C2-C3: Mild right neural foraminal narrowing. Mild left neural foraminal narrowing. Moderate disc degenerative disease.
C3-C4: Moderate right neural foraminal narrowing. Mild left neural foraminal narrowing. Moderate disc degenerative disease.
C4-C5: Moderate right neural foraminal narrowing. Moderate left neural foraminal narrowing. Mild disc degenerative disease with mild posterior disc bulge.
C5-C6: Moderate right neural foraminal narrowing. Moderate left neural foraminal narrowing. Mild disc degenerative disease with mild posterior disc bulge.
C6-C7: Moderate right neural foraminal narrowing. Moderate left neural foraminal narrowing. Mild disc degenerative disease with mild posterior disc bulge.
C7-T1: Mild disc degenerative disease.
Cord: No abnormal cord signal. No abnormal epidural or leptomeningeal
enhancement.
Visualized brain: Normal.
Additional comment: Prominent cervical lymph nodes, likely reactive.
IMPRESSION:
1. Erosive change of the dens/anterior arch of C1, with widening of the atlantodental interval and moderate prevertebral soft tissue edema/enhancement as described above. Given patient's reported history of MSSA bacteremia, findings are concerning for atlantodental osteomyelitis.