The conus medullaris is affected by many conditions, including congenital, vascular, tumoral, inflammatory and infectious diseases, which many times are hardly differentiated because of the similarity of their clinical history and physical examination among different etiologies. Magnetic resonance imaging presents high sensitivity in the detection of these lesions and plays a relevant role in the diagnosis and in the evolutive controlThis panel aims to: Review the anatomy of the conus medullaris, including its anatomical limits, normal MR imaging findings and related clinical syndromes. Discuss and illustrate the imaging patterns of the main lesions in the conus medularis, including congenital, vascular, tumoral, inflammatory, infectious, among others. - Describe through illustrative cases the scenarios for diagnosis, focusing on typical imaging patterns, unexpected findings and red flags that aid the diagnosis.

- Anatomy of the conus medullaris - Normal appearance on CT and MRI-Main pathologies involving the conus medullaris, involving: -Congenital lesions: Caudal regression syndrome types 1 and 2, Ventriculus terminalis, Myelomeningocele -Neoplasic lesins: myxopapilar ependymoma, tanicytic ependymoma, leptomeningeal carcinomatosis, metastatic lesion, glioblastoma, dermoid cyst -Vascular lesions: arteriovenous dural fistula, cavernoma, ischemia-Systemic inflammatory diseases: IGG-4 related disease, Sarcoidosis, Dermatomyositis -Infectious diseases: Schistosomiasis, Tuberculosis, Herpes Virus, Polio-like-Auto-immune diseases: MOG antibody disease, Multiple Sclerosis, NMSOD - Red flags and diagnostic tips - Diagnostic Approach - Final remarks