When neck pain, numbness, or tingling in the arms sends you for a cervical spine MRI, you expect clear answers. You've done the exam, but what happens when your report says “normal” or “mild changes” and you still don’t feel right?
You’re not alone. Many patients find that their symptoms don’t match their imaging report, and they worry if something could have been missed.
The short answer is yes, unfortunately it’s possible. While MRI is the most sensitive tool for viewing the spine and spinal cord, the accuracy of your results depends heavily on who reads the scan and their experience with this complex area of the body.
That’s where a neuroradiologist or spine-specialized radiologist can make all the difference.
Why Cervical Spine MRIs Are Easy to Misread
The cervical spine (neck region) contains delicate structures including vertebrae, discs, nerves, the spinal cord, ligaments, and blood vessels, all packed into a small space.
Even with high-quality MRI images, subtle findings can be overlooked, misinterpreted, or downplayed by a general radiologist who reads many different body parts in a day, from lungs to knees to brains.
A neuroradiologist, on the other hand, focuses specifically on imaging of the brain, spine, and nerves. They are trained to recognize small but clinically important changes that can explain persistent symptoms.
Common Diagnoses Seen on Cervical Spine MRI
Here are some of the most frequent findings when a cervical spine MRI is interpreted by an expert:
- Disc bulge or herniation: A portion of the spinal disc protrudes, pressing on nerves or the spinal cord.
- Foraminal stenosis: Narrowing of the passage where nerves exit the spine, often the cause of arm pain or tingling.
- Degenerative disc disease: Wear-and-tear changes that can lead to chronic stiffness or neck pain.
- Facet joint arthritis: Arthritic changes in the small joints at the back of the spine that can cause localized or referred pain.
- Spinal cord compression (myelopathy): Pressure on the cord leading to balance issues, weakness, or coordination problems.
- Post-surgical scarring or recurrent disc herniation: In patients with prior surgery, distinguishing between scar tissue and a new problem is crucial.
These are the conditions most general radiologists recognize, but even within these, the degree of nerve or cord compression is often undercalled, or subtle impingement may be described as “mild” despite significant symptoms.
Subtle or Uncommon Findings That May Be Overlooked
A neuroradiologist’s training allows them to detect findings that can easily be missed or dismissed on an initial read:
1. Subtle Nerve Root Compression
Tiny osteophytes (bone spurs) or asymmetric disc bulges can pinch a nerve root in just one small slice of the MRI. This may not be mentioned if the compression isn’t dramatic, but it can absolutely cause radiating pain or numbness.
2. Early or Subtle Myelopathy
Before the spinal cord shows obvious compression, it can develop signal changes (tiny bright spots) indicating early damage. A specialist will look closely for these changes, which can be the key to preventing permanent symptoms.
3. Atlantoaxial Instability or Ligamentous Injury
These injuries occur high in the cervical spine (C1–C2) and are often overlooked in trauma or whiplash cases. A neuroradiologist knows to evaluate subtle alignment issues and ligament signal abnormalities that might explain severe neck pain or dizziness.
4. Demyelinating or Inflammatory Conditions
Conditions like multiple sclerosis (MS) or transverse myelitis can first show up on a cervical spine MRI, but early lesions may be small or atypical in appearance. A neuroradiologist considers these possibilities when subtle signal changes are seen in the cord.
5. Chiari Malformation or Syrinx
A Chiari I malformation (where the cerebellum dips below the skull base) or a syrinx (fluid-filled cavity in the spinal cord) can cause neck and arm symptoms but may be missed if the MRI is cropped too low or not read by someone attuned to these patterns.
6. Venous Congestion or Vascular Compression
Rarely, abnormal veins or arteries in the cervical region can compress nerves or the cord. A neuroradiologist knows when to recommend advanced imaging (like MR angiography) to clarify these subtle causes.
How a Specialist Second Opinion Can Help
If your report says “mild degenerative changes” or “no significant abnormality,” yet you’re still in pain, it’s reasonable to ask for a second opinion from a neuroradiologist.
A specialist review can:
- Confirm whether your first report was accurate
- Identify subtle findings that may have been overlooked
- Correlate imaging results with your specific symptoms
- Offer clarity before you pursue invasive treatments or surgery
At MDView, patients can upload their MRI and get a second opinion from a board-certified neuroradiologist who reads cervical spine imaging every day, with a detailed report delivered within 72 hours or less.
When to Consider a C-Spine Second Opinion
You may benefit from a specialist review if:
- Your symptoms don’t match the MRI findings
- You’ve been told “nothing significant” was found
- You’re considering surgery or injections
- Your symptoms have worsened over time
- Your initial MRI was read at a general imaging center
Cervical spine MRIs are powerful tools but only when interpreted by the right eyes. A neuroradiologist’s specialized expertise can mean the difference between “no findings” and the real answer behind your pain.
If you’re questioning your results or planning a major decision based on them, getting a specialist second opinion isn’t overreacting — it’s being proactive about your health.
Have questions about your cervical spine MRI? Upload your images to MDView to have them reviewed by a neuroradiologist fast! Gain peace of mind and possibly a crucial new perspective before your next step.
Get started today at https://app.mdview.com to upload your exam and get connected with an expert radiologist for a trusted second opinion report.