Fast Five Quiz: Multiple Sclerosis Presentation and Diagnosis

Christopher Luzzio, MD


July 30, 2020

MRI is the primary imaging modality for diagnosing and monitoring MS patients. Its positive predictive value far surpasses that of all other tests. In order to establish an accurate diagnosis, the MRI findings must be correlated with a patient's neurologic history and clinical findings. MRI lesion load and location often do not predict clinical symptoms and physical exam findings, however. All patients with relapsing forms of MS should have MRI imaging of the brain and/or spinal cord at individualized frequencies, depending in particular on clinical course, relapses, and medication changes.

Before MRI was available, CT scanning was used to identify MS lesions. CT has limited sensitivity, however, and currently has no essential role in the diagnosis and treatment of MS. Likewise, the use of angiography is limited in MS but may be considered when central nervous system vasculitis is part of the differential diagnosis for a patient being evaluated for MS. There are no specific angiographic findings in MS.

Learn more about brain imaging in MS.


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