Differential Diagnosis for Degenerative Endplate Irregularity and Signal Abnormality
Single Most Likely Diagnosis
- Degenerative Disc Disease: This is the most likely diagnosis given the description of degenerative endplate irregularity and signal abnormality at multiple levels (C4-C5 through C6-7). The presence of minimal edema at C5-6 further supports this diagnosis, as it can be associated with the inflammatory response seen in degenerative disc disease.
Other Likely Diagnoses
- Spondylosis: This condition, characterized by degenerative changes in the spine, can lead to endplate irregularities and signal abnormalities due to the degeneration of the intervertebral discs and the vertebral endplates themselves.
- Discitis/Osteomyelitis (Chronic): Although the presence of minimal edema might suggest an inflammatory process, chronic discitis or osteomyelitis could present with degenerative changes and signal abnormalities, especially if the infection has been ongoing and has led to structural changes in the spine.
Do Not Miss Diagnoses
- Infectious Spondylodiscitis: This is a serious condition that requires prompt diagnosis and treatment. The presence of edema and signal abnormalities could be indicative of an infectious process, especially if there are systemic symptoms such as fever or if the patient is immunocompromised.
- Spinal Tumor: Although less likely, a tumor could cause degenerative changes and signal abnormalities, especially if it involves the vertebral bodies or discs. The presence of edema could indicate tumor infiltration or associated inflammation.
- Trauma: Acute or chronic trauma to the cervical spine could result in degenerative changes, signal abnormalities, and edema, especially if there has been an injury that has not been properly diagnosed or managed.
Rare Diagnoses
- Scheuermann's Disease: This condition is characterized by kyphosis of the spine and can involve the cervical region, leading to degenerative changes. However, it typically presents in adolescence and might not fully account for the signal abnormalities described.
- Anderson Lesions: These are rare lesions that can occur in the spine and might present with signal abnormalities and degenerative changes, but they are not commonly encountered and would be an unusual cause of the described findings.