Fast Five Quiz: Multiple Sclerosis Diagnosis and Workup

Christopher Luzzio, MD


November 22, 2022

The diagnosis of MS is based on a combination of clinical, MRI, and laboratory (eg, CSF) findings. Misdiagnosis may have harmful consequences if patients are inappropriately started on disease-modifying therapies. The differential diagnosis of MS includes other CNS inflammatory conditions, CNS infections, metabolic conditions, and vascular disease.

While MS can be clinically diagnosed on the basis of the history and examination providing evidence of typical neurologic dysfunction, MRI is now routinely used to confirm the diagnosis. Importantly, the diagnostic criteria are designed to be used for patients with typical clinical presentations; they should not be employed in cases where MRI changes are incidentally identified in asymptomatic individuals. Such cases are referred to as radiologically isolated syndrome.

It is essential that both primary and metastatic spinal cord neoplasms should be considered in the differential diagnosis of MS. The presence of cysts and hemorrhage on imaging studies support the diagnosis of neoplasm.

Learn more about the differential diagnosis of MS.

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