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Traditionally, when symptoms as discussed previously led a physician to suspect a Chiari malformation, plain X-rays of the head and spine were performed followed by a myelogram (a contrast agent is injected via a spinal tap into the spinal fluid and then a series of X-rays are taken that image the spinal fluid space and its contents, including the spinal cord and nerve roots). Due to the test’s invasive nature, there was always a reluctance to perform it until the severity of the symptoms warranted it. The introduction of modern imaging techniques, specifically MRI, has radically changed the evaluation of symptoms referable to the spinal cord. This test is noninvasive and as a consequence is performed much earlier in the evolution of the condition, frequently before permanent injury has occurred within the nervous system. MRI is now the procedure of choice for imaging the spinal cord and the fluid surrounding it. There are several different types of studies used to delineate normal from abnormal anatomy. The resolution of these studies approaches that of the actual anatomy, so the treating physician can gain a good understanding of the anatomical substrate that is giving rise to the symptoms. If there is concern about the surrounding bony spine, a computed tomography (CT) scan is usually used since it can better show the bony anatomy.