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Asymptomatic spinal cord lesions are found in 30%– 50% of people with a clinically isolated syndrome (CIS).1–3 Spinal cord magnetic resonance imaging (MRI) can assist in the diagnosis of multiple sclerosis (MS) in CIS patients,4 particularly in the subgroup of patients without evidence of dissemination in space on brain MRI at the time of presentation.2,3 Because typical short-segment spinal cord lesions are a relatively specific finding to MS, spinal cord MRI may also assist in differential diagnosis, and may be helpful in avoiding misdiagnosis.5

Do spinal cord lesions matter in patients with clinically isolated syndrome and early MS?