Use the combination of cape-like sensory loss, Chiari symptoms, and MRI pattern to distinguish syringomyelia from intramedullary tumor and degenerative endplate disease. Document the lesion level and the management step it implies.

Syringomyelia causes a cape-like dissociated sensory loss; Chiari malformation can present with occipital headache, dysphagia, and spasticity; Intramedullary tumors are commonly ependymomas or astrocytomas; Modic endplate changes are distinct MRI signal patterns in vertebral endplates; Long-standing compression can produce irreversible spinal cord injury