Differential diagnosis of multiple sclerosis and other inflammatory CNS diseases

Multiple sclerosis (MS) is the most common acquired demyelinating disorder of the central nervous system (CNS). Diagnosing MS can be very challenging owing to its variable clinical features and lack of specific tests. Magnetic resonance imaging (MRI) is a key measure in this process. Although white matter lesions on brain MRI are regarded as a hallmark of MS, they are a common radiological finding and their pattern may overlap in particular CNS inflammatory diseases. The increasing availability of therapies for MS and the knowledge of benefits associated with an early treatment underscore the importance of precise and quick diagnosis. Despite an extensive research, currently no fully specific diagnostic test is available to distinguish between CNS inflammatory disorders. In this review, we discuss characteristic findings and distinctive features of CNS inflammatory disorders, with particular focus on rheumatic diseases.