title: Spondylotic myelopathy mimicking myelitis: diagnostic clues by magnetic resonance imaging.
abstract: BACKGROUND
  Spondylotic myelopathy is the commonest cause of nontraumatic myelopathy. Radiological features of spondylotic myelopathy can often overlap with inflammatory myelopathies which may lead to a delayed or incorrect diagnosis and therapy. A distinctive gadolinium enhancement pattern recently described may help to differentiate spondylotic from inflammatory myelopathy.
  
  
  METHODS
  Case 1: a 38-years-old man presented with a 2-year history of paresthesias in the upper extremities, and one year later cramps on the right limbs and numbness over right C5 and C6 dermatomes, related to movement of the neck. Case 2: a 44-year-old man presented with a 1-year history of progressive gait difficulties and sensory disturbance in the hands, and a recent onset of bladder dysfunction. In both cases, spinal cord MRI identified a longitudinal cervical T2-signal hyperintensity associated with a pancakelike transverse band of gadolinium enhancement just below the site of maximum spinal stenosis, and circumferential or hemicord enhancement on axial images.
  
  
  CONCLUSIONS
  The radiological features of spondylotic myelopathy may resemble those of inflammatory origin. The recognition of a transverse pancakelike gadolinium enhancement immediately below the site of maximal compression as a typical radiological pattern of spondylotic myelopathy is important to reduce the risk of misdiagnosis and to help in the management of these patients.
authors.forename: Adriana
authors.initials: A
authors.lastname: Rua
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Blanco
authors.forename: María
authors.initials: M
authors.lastname: Sepúlveda
authors.forename: Núria
authors.initials: N
authors.lastname: Sola-Valls
authors.forename: Eugenia
authors.initials: E
authors.lastname: Martínez-Hernández
authors.forename: Sara
authors.initials: S
authors.lastname: Llufriu
authors.forename: Joan
authors.initials: J
authors.lastname: Berenguer
authors.forename: Francesc
authors.initials: F
authors.lastname: Graus
authors.affiliation: Hospital Clinic de Barcelona. Institut Clinic de Malalties del Sistema Nervios, 08036 Barcelona, Espana.
authors.forename: Albert
authors.initials: A
authors.lastname: Saiz
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005682:Gadolinium; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009187:Myelitis / Q000175:diagnosis; D010292:Paresthesia / Q000209:etiology; D013117:Spinal Cord Compression / Q000175:diagnosis* / Q000209:etiology; D013130:Spinal Stenosis / Q000150:complications*; D055009:Spondylosis / Q000150:complications*; D016312:Treatment Refusal; D014555:Urination Disorders / Q000209:etiology
chemical_list: D003287:Contrast Media; D005682:Gadolinium