Clinical Presentation

A 37-year-old woman presenting with motor and sensory disturbances in the arms and legs after a motor vehicle accident.

(A) Sagittal T2-weighted image (WI) shows subluxation and disk edema at C5-C6 with posterior osteophytes. Narrowing of the canal and edema of the cord (between arrowheads) are noted. (B) Sagittal T1WI shows subluxation and disk widening at C5-C6 (arrow). There are posterior osteophytes. (C) Note the central cord edema on the axial T2WI (arrow). No cord hemorrhage is demonstrated.

Differential Diagnosis

• Cord contusion: Contusions tend to be severe in patients with degenerative changes. Magnetic resonance imaging (MRI) demonstrates increased cord signal and cord expansion.

• Wallerian degeneration of the cord: This develops in the subacute phase (about 1 month) after spinal cord injury. MRI reveals hyperintense signal on T2WIs in the white matter tracts above (dorsal columns) and below (lateral columns) the level of the injury.