Imaging of Spinal Cord Inflammatory Disorders

Inflammatory myelopathies comprise a group of spinal cord disorders with overlapping clinical manifestations but distinct etiologies, prognoses, and treatment implications. This article highlights the role of magnetic resonance imaging (MRI) in differentiating immune-mediated causes of myelitis, including multiple sclerosis, aquaporin-4-positive neuromyelitis optica spectrum disorder, myelin oligodendrocyte glycoprotein antibody-associated disease, glial fibrillary acidic protein astrocytopathy, immune checkpoint inhibitor-related neuroinflammatory conditions, paraneoplastic syndromes, and systemic autoimmune diseases. MRI patterns, including longitudinal lesion length, axial distribution, enhancement characteristics, and temporal evolution, are discussed alongside clinical/paraclinical correlates. Disease-specific imaging features, common mimics, and emerging imaging techniques are examined.