Fast Five Quiz: Multiple Sclerosis Diagnosis and Workup

Christopher Luzzio, MD


November 22, 2022

Radiography has a limited role in the diagnosis and treatment of MS. Infrequently, plain radiographs may be used to exclude mechanical bony lesions.

According to 2021 consensus recommendations from the Magnetic Resonance Imaging in Multiple Sclerosis network, the Consortium of Multiple Sclerosis Centers, and the North American Imaging in MS Cooperative, a brain MRI with gadolinium is recommended for the diagnosis of MS. If the brain MRI is nondiagnostic or if the presenting symptoms are at the level of the spinal cord, a spinal cord MRI is recommended.

Lumbar puncture with CSF analysis is no longer routinely used in the investigation of MS; however, it may be useful when MRI is unobtainable, or MRI findings are nondiagnostic. In such cases, CSF is evaluated for OCBs and intrathecal immunoglobulin G production, as well as for signs of infection.

Learn more about imaging studies in the diagnosis and workup for MS.


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