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When confronted by a patient with the radiologically isolated syndrome
  1. Jeremy Chataway
  1. Correspondence to Dr J Chataway, Consultant Neurologist, National Hospital for Neurology and Neurosurgery, University College London Hospitals Foundation NHS Trust, Queen Square, London WC1N 3BG, UK; jeremychataway{at}


As MRI becomes ever easier to access, it is clear that there is a group of patients, scanned for a wide range of symptoms, where the imaging looks inflammatory, despite the discordance with the clinical presentation. This is the so-called radiologically isolated syndrome, which can be a source of anxiety and difficulty for both patient and clinician. The evidence for its relationship to the clinically isolated syndrome and therefore to multiple sclerosis is presented, and I will describe a pragmatic approach to managing the situation.

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  • Provenance and peer review Commissioned; externally peer reviewed.

  • Competing interests None.

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