Imaging Approach to Myelopathies

Myelopathy refers to spinal cord involvement from diverse etiologies resulting in neurologic symptoms. The presentation is variable, often posing a diagnostic challenge due to overlapping clinical and imaging features. Classification by symptom onset aids in the differential diagnosis and is based on hyperacute, acute/subacute, and chronic presentations, each carrying distinct prognoses. MR imaging is pivotal for diagnosis, providing detailed characterization of spinal cord involvement. This article offers a comprehensive overview of various diseases causing myelopathy, their imaging manifestations, differential diagnoses, and diagnostic algorithms, emphasizing the role of MR imaging in facilitating prompt identification of underlying causes and guiding optimal management.