Weekly Image Challenge – August 20, 2023

What is the most likely diagnosis for this 38 years old lady with left upper extremity weakness and neck pain?

  1. Astrocytoma
  2. Ependymoma
  3. Syringomyelia only
  4. Meningioma
  5. Spinal AVM


It’s an ependymoma. The sausage shape, intramedullary location & hypo-intense signals towards the lower end are important characteristics (not a typical cap sign here). Proximal syringomyelia. Astrocytoma are more common here, but they are usually less cystic.