"The radiographic finding of bright spotty lesions in a patient presenting with acute myelitis is very specific (~90-100%) for neuromyelitis optica spectrum disorder (NMOSD), but not as sensitive (~30-70%) 1. Thus, presence of bright spotty lesions has been found to be a useful radiographic marker in differentiating myelitis due to neuromyelitis optica spectrum disorder (NMOSD) from other conditions that cause myelitis or a myelitis-like appearance but where bright spotty lesions are rarely seen, including multiple sclerosis, myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), idiopathic transverse myelitis, and spinal cord infarction 1,3-6."