Imaging Findings:  The radiograph shows a congenital fusion of the C3 and C4 vertebrae, i.e., a block vertebra.

Discussion:  The block vertebra could result in a lack of normal range of motion of the cervical vertebrae causing extra stress on the C2-3 and C4-5 disk spaces.  This stress could lead to an intervertebral disk extrusion.  Other differentials include infectious or inflammatory disease or neoplasia. 

Question:  Based on this assessment, what next step would be best to find the problem?

A)   Cervical radiographs-flexed
B)   Myelogram
C)   CT
D)   MRI
E)   Conservative management