A Faster Way to Diagnose Multiple Sclerosis

BACKGROUND: The central vein sign (CVS) was included in 2024 McDonald criteria but remains underutilized in clinical practice. Implementation of CVS may reduce the requirement for lumbar punctures (LPs). At Nottingham, UK academic multiple sclerosis (MS) center, we implemented a fast-track (FT) pathway incorporating CVS analysis for people referred with imaging suggestive of MS as part of a quality improvement project. We retrospectively reviewed consecutive patients diagnosed with MS referred between March 1, 2024, and July 31, 2025. RECENT FINDINGS: = 0.003). No people with MS in FT pathway received a LP. The mean cost per patient was £707 (FT) vs £999 (outpatient). IMPLICATIONS: Routine application of CVS within a structured diagnostic pathway accelerated diagnosis, eliminated LPs, and reduced costs. Our findings support a broader adoption of CVS to streamline MS workup.