What tests are done to diagnose transverse myelitis?
Your doctor will first review your medical history and perform a physical examination.
If this review suggests a problem with the spinal cord, the doctor will do further tests to:
- Eliminate the possibility that something other than inflammation is affecting the spinal cord, for example, a tumor, herniated disc, or a compression caused by an abscess.
- Confirm the presence of abnormal inflammation within the spinal cord.
- Identify the cause of the abnormal inflammation.
The diagnosis of TM is considered when patients develop subacute (over a few days) spinal cord symptoms and signs as described above, and magnetic resonance imaging (MRI) or other imaging does not show another cause for the spinal cord disorders.
MRI often shows a long segment of altered signal in the spinal cord which extends to multiple segments along the spinal cord, likely reflecting demyelination and nerve injury in the spinal cord. This may sometimes be associated with swelling of the spinal cord. Demyelination is a process in which the myelin, or coating, which covers many nerve fibers is stripped off by disease.
A test of cerebrospinal fluid may show increased white cells and protein. In TM, the spinal fluid frequently shows an increase in white blood cells at levels that may be higher than levels usually seen in MS. Also, patients with TM usually do not have oligoclonal banding, which is relatively common in MS. Oligoclonal bands are bands of proteins seen in certain spinal fluid tests that indicate immune system activity in and around the spinal fluid pathways.