Radiologically isolated Syndromes

Definition

· MRI features suggestive of MS in asymptomatic patients or who have likely unrelated conditions (e.g. headache, dizziness)

Diagnostic Criteria

· 2024 McDonald criteria for RIS

· See MS topic for CNS topographies and other definitions

·

Higher threshold required in specific groups:

· >50 years

· Referral for headache

· Vascular risk factors

Risk of progression

· 2 years - 19%

· 5 years – 35%

· 10 years – 51%

· Can be stratified by risk factors: Spinal lesions, Gad +, OCB, DIT

o If 4 RF’s – 89% conversion

o If 0-1 RF – 29% conversion