History: 60 years old. Bilateral leg weakness. Query cauda equina compression.
Findings: The lowest fully-formed disc is taken to represent L5/S1. There are mild spondylotic changes, but the cauda equina is not compressed.
At T12 level there is the appearance of an intramedullary lesion just above the conus, with surrounding oedema in the cord. Unfortunately, axial images do not cover this region. There are degenerative bone marrow signal change, but no bone metastasis is identified.
Opinion: Small intramedullary lesion at T12. The appearances are not specific, but could represent an ependymoma, metastasis, or other intramedullary tumour such as lymphoma. Completion imaging of the whole spine with contrast, and body imaging starting with CT chest/abdomen/pelvis is suggested.