Is there a test to determine the difference between a cord myelomalacia and demelinating plaque?

Cervical spine : I deal with this alot with my ms patients that also have spine arthritis. If there is compression from disc bulges or stenosis and there are spinal cord changes on imaging and they are symptomatic i consult with the neurologist and usually recommend surgery. A finding on imaging without any arthritis in the area could be considered likely from ms.

MRI: The best imaging approach is via MRI, and a variety of software applications can sort out characteristics of a focal spinal cord lesion. Myelomalacia simply means damage to spinal cord, and is characteristic of trauma, extrinsic compressive lesion, cord infarct due to stroke, and may also be seen in MS, but more severe in neuromyelitis optica.