Spinal Cord Myelopathies: Overview, Imaging Approach, and Differential Diagnosis: Part 1.

Myelopathy refers to a pathologic process involving the spinal cord that encompasses a heterogeneous spectrum of clinical presentations with distinct etiologies, prognoses, and management strategies. As symptoms are often nonspecific and clinical localization can be challenging, imaging-particularly MR imaging-plays a pivotal role in diagnosis. A structured, pattern-based imaging approach is essential for accurate interpretation, integrating symptom acuity and physical examination findings with lesion localization, extent, signal characteristics, enhancement patterns, temporal evolution, and associated extraspinal pathology. This section additionally focuses on the causes of compressive myelopathy.