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Old 10-21-2004, 10:57 PM   #1
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Haw'nCarl HB User
Exclamation Incidental Finding

I had an MRI on Tuesday, which was a day shy of my eight-month post-op anniversary. I have still been having some nerve pain in my right leg along with some other issues so an MRI seemed warranted.

I spoke to my nurse case manager earlier today (this is a W/C case) and he was gloating that nothing showed up on the MRI that would cause any of the symptoms that I was describing.

I have never had an EMG, so if anyone could please post as to what I should expect I would appreciate it because I think that would be the next logical step. This is definitely not a figment of my imagination and if the MRI does not show any nerve impingement that would cause radicular pain what else could they do to pinpoint the problem. I am worried that it may be permanent damage that occurred prior to surgery. If this is the case would an EMG qualify that?

To the point of the title of this thread, the individual who initially read my MRI results put in his report an “incidental finding” of fluid retention. Now I am only going on my conversation with my case manager, as I have not seen the actual report. He also described the “incidental finding” as a cyst. Needless to say this caused some concern for me that prompted me to post something here before seeing the actual report to see what kind of feedback I get. I asked if this was a product of the surgery and he said that it was.

Seeing the actual report will probably clear up nothing for me because as a lot of you know these reports are written in a language that only a student in their 7th year of med school can understand. I have a copy of the film, but I can't make heads or tails out of them either. The hardware sure did cause a lot of interference, at least that's what I would describe it as. I still have copies of my pre-surgery MRI's, and they are much clearer than this one. Anyway, I may write an addendum to this post once I receive my MRI report.

What a crying game chronic pain can perpetuate. Any and all similar stories, experience, suggestions, encouragement, or cajoling are welcomed.

Carl
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Old 10-21-2004, 11:31 PM   #2
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AlSmith HB User
Re: Incidental Finding

Hey Carl, I am sorry you are still having problems. I don't know how much you know about an EMG so I be basic. The test is to determine nerve conduction. The neurologist will put electrodes on you to pick up nerve signals. He will then insert a needle in muscles that match to certain nerve roots to see if there is any interference in the nerve signal. He may also send an electrical jolt through your nerve to make sure the nerve works. It is not the funnest test but it goes fairly quickly and if there is interference with the nerve, it should show it.

The "cysts" may be synovial cysts. You should do an internet search to see what comes up. I do not know much about them but there are a few threads that may help you. I hope you get some answers soon.

Alan

 
Old 10-21-2004, 11:33 PM   #3
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mel1977 HB User
Re: Incidental Finding

during the EMG they will have you lie on your back and you will have to relax as much as possible. Then they stick tiny needles (one at a time) into various muscles (I assume into nerve pathways). They will ask you to flex-it can be painful, and some muscles (like calf) may feel like they are cramping. Then they will move the needle around while in your muscle. There is a sound it makes-but I don't know what they look for on the monitor or listen for. When they did my left arm (where my pain was) the pain shot up my arm, shoulder, neck. It was the same pain I had the day all this started. The doc agreed that it was the area where a nerve was pinched (though my MRI shows no nerve impingement). They also may do a nerve conduction test. Same scenario, but they kinda "shock" the muscle and see how it reacts. It is uncomfortable. That is the best way I can describe it. Good luck to you!

 
Old 10-22-2004, 06:50 AM   #4
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MarianJ HB User
Re: Incidental Finding

[COLOR=Indigo][CENTER][B]Hello Carl [/B] [/CENTER]
[INDENT]I am sorry to hear that you are still in pain. I do agree with you on requesting that your doctor send you for an EMG. It took me so long to finally persuade my neuro surgeon to give me a referral to have this test. He had first sent me for a Cat Scan, MRI and then Myelogram. He then told me that my leg and foot pain was probably Fibromyalgia and sent me to a Rheumatologist who only confirmed that diagnosis. When I only got worse and told him this and asked him to please send me for them, he told me that I was only torturing myself. Well, you can read my very long signature to see my results.... I now have to make an appointment with my rheum to ask if I do indeed have Fibromyalgia...

As for the EMG, they did the electrodes part first to test the nerve signals as Alan stated. The part that hurt me was the upper part of the legs. The bottom of my legs didn't hurt as much, and I didn't feel the signal's in the feet. Two nurses had performed this part of the test on me. Afterwards the neurologist came in and he conducted the needle study for the muscles at Mel had explained. I did have three Emg's as I had both legs tested and one arm. My test lasted for two and a half hours. Much longer than scheduled because they had found some problems. Also the neurologist then asked if he could check my neck and back with the needles as well. He had wanted to find where the damage may be coming from. But my muscle study came back fine. The first couple of needles did hurt a little but then I got use to them and they really didn't bother me. Good Luck...[/INDENT]
[CENTER][B] Jeanne [/B] [/CENTER] [/COLOR]
____________________
[COLOR=DarkSlateBlue][B]~[U]LUMBAR[/U]~[/B]
Posterolateral Fusion & Infuse with Laminectomy & Discectomy on L4,L5,S1 June 2003
Instrumentation = 2 Rods, 6 Screws, 2 Disc Spacers
[U]Lumbar MRI 1/20/04[/U]
Impression:
Small amout of post operative fluid collection at level L4 which does not appear to communicate with the thecal sac.
Encasement of the thecal sac at L4-5 level by enchancing soft tissue, consistent with epidural fibrosis.
Displacement of the left S1 nerve root, consistent with epidural fibrosis.
[U]Lumbar Myelogram 2/26/04[/U]
Impression:
Mild indentation on the subarachnoid space is noted at the level of L4-5 & L5-S1 where there is non-specific soft tissue slightly displacing the subarachnoid space.
[U]Lumbar Post Myelogram 2/26/04[/U]
Impression:
L4-5 non-specific soft tissue is noted in the dorsal & ventral epidural space..
L5-S1, there is non-specific soft tissue noted in the ventral epidural space slightly displacing the dural sac posteriorly.
[U]EMG 9/13/04[/U]
Distal Peroneal Neuropathy Bilaterally
Bilateral Chronic L4 versus L5 Radiculopathy
[B]~[U]CERVICAL[/U]~[/B]
Straightening of the Normal Cervical Lordosis.
Mild Congenital Narrowing of the Spinal Canal.
C4-5, C5-6, C6-7 Herniated Discs
C4-5 & C5-6 , Cord Flattening at these levels.

[B]Fibromyalgia, Arthritis, Bursitis, Tendonitis, Diabetes,
Anemia, Asthma, Acid Reflux, Migraine's[/B][/COLOR]

 
Old 10-22-2004, 12:40 PM   #5
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TexasWildRose04 HB User
Re: Incidental Finding

Hiya Carl....

Sorry you are still having such pain......seems like a never ending vicious cycle for us all.......but about the EMG/NCV.......They did the electrode part on my legs first.....they had me lay flat on my back and stuck electrodes to my leg... then he would send send waves into it... and make my leg jump.... he would continue to make the waves stronger until my leg jumped I suppose to the extent he wanted.....then he did my other leg..... there were a few times that it did hurt I have to admit when he was zapping me and the waves got quite strong........while he was doing this he had me turn to my sides and so on... so he could put the electrodes on the backs of my leg and such.......He did one leg... and then the other.........Then came the painful part.......

The doctor had me return to laying flat on my back... then he inserted a needle in various places on my leg....he did one leg at a time..... stuck me in the top of my foot....on my calves.... right above my knee... front and back.....thighs... front and back......several places.... and would have me flex my muscles and then relax.... I have to say it did hurt quite badly a few times..... but the worst of all was when he had me turn on my side and lay in the fetal position and then he stuck the needle in my lower back right beside of my scar from my surgery....... OH MY GOD!!! I about came off the table... I know I probably could have made a few sailors blush.....that hurt so bad....I was in a full sweat.... I think my procedure was about 1 hr or so..... long enough....my legs were quite fatigued afterwards... and sore for a couple days following...

Not to frighten you or anything... just letting you know what to expect.....for some if they know what to expect it makes it better... some it makes it worse....but at any rate, I hope yours goes smoothly... and it gives you the answers you are looking for..... Best of luck to you........ Take Care...........

April

 
Old 10-22-2004, 01:04 PM   #6
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mlachowicz HB User
Re: Incidental Finding

Hey Carl:
I AM SHOCKED!!!!!!!!!!!!!!!! Take a look at my post a few days again about synovial cysts! I am trying to gather as much info as I can. Keep me posted!
~M~

 
Old 10-22-2004, 03:43 PM   #7
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lfoster21 HB User
Wink Re: Incidental Finding

Wow, I had hoped things were turnig for the good for you. I am sorry you are still having problems. I won't go into the procedure of the EMG, because everyone has done such a good job...I will say though it wasn't as bad as I had worked myself into thinking it would be. There were maybe 2 times that hurt more than the other times but it was quick. The rest of the time was just uncomfortable. It lasted about 1 1/2 hrs. for both the emg and the nerve conduct test.

I will be praying for you and good luck,

Lorie
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Old 10-22-2004, 08:35 PM   #8
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PaulaZ HB User
Re: Incidental Finding

Carl,

I'm so sorry you're still having pain. It gets old doesn't it?

The EMG really isn't that bad. I've had several and although they're not my favorite thing to do, I've had worse tests.....colonoscopy, etc.
But like April said it depends on where they put it....OUCH!

I'm concerned about that cyst, though. Maybe that's putting some pressure on the nerve. I don't know much about them, but they DO take up space, right? Just a thought.....

Good luck and I hope you find answers soon.

Paula

 
Old 10-24-2004, 04:23 PM   #9
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Haw'nCarl HB User
Re: Incidental Finding

[QUOTE=TexasWildRose04]stuck electrodes to my leg...make my leg jump....it did hurt I have to admit....Then came the painful part.......then he inserted a needle in various places on my leg....stuck me in the top of my foot....on my calves.... right above my knee... front and back.....thighs... front and back......several places....I have to say it did hurt quite badly.... but the worst of all was when he had me turn on my side and lay in the fetal position and then he stuck the needle in my lower back right beside of my scar from my surgery....... [B]OH MY GOD!!![/B] I know I probably could have made a few sailors blush.....that hurt so bad....I was in a full sweat....and sore for a couple days following...[B]Not to frighten you or anything[/B]... just letting you know what to expect.....[/QUOTE]Gee April….thanks! Your post sounded like it was taken right out of a Stephen King novel. Or maybe you plagiarized the ever so popular manual, “Torturing for dummies”.

“Not to frighten you or anything” What! I am scared out of my wits now! But seriously, thanks for the heads up everyone, very informative. I see my doctor tomorrow so I will be privy to the actual MRI report and will be able to eliminate all speculation and conjecture from my case manager. This cyst thing puts a bad taste into my mouth.

~M~, I know, I read your post on the cysts, and I am wondering if this is the same thing as is being described for me. I’ll let you know.

Jeanne, I hope you are doing well; it’s always nice to hear from you, as well as Alan, Mel, ~M~, Lorie, Paula, and yes you April. I was just razzin ya, I hope you didn’t mind too much. Thanks again all for the informative and detailed personal accounts, encouragement, thoughts and prayers...right back at ya.

Carl
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3level laminectomy,discectomy&PLIF L3-S1 02/20/04
6cages 8screws 2rods (oh my!) w/local bone graft
Success! Yay!

 
Old 10-24-2004, 04:30 PM   #10
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lfoster21 HB User
Wink Re: Incidental Finding

Good luck tomorrow, Carl. I hope you are able to get the answers that you need. Keep us posted on the results.

God Bless,

Lorie
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Old 10-25-2004, 05:29 PM   #11
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mlachowicz HB User
Re: Incidental Finding

Hey Carl.. How did it go? I am VERY interested!!!
~M~

 
Old 10-25-2004, 11:29 PM   #12
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Haw'nCarl HB User
Re: Incidental Finding

Aloha All,

Well, I guess its good news; everyone is saying that it’s nothing to worry about. If anyone is interested, please post and I will type the report verbatim. There are still a lot of maybes in my mind and the report is far from definitive, I guess time will tell and I have to hope for the best.

I am praying for a favorable outcome for you ~M~, what is the latest on your quest for info?

Again, if anyone is interested in my MRI report, I would be happy to post it.

Carl
__________________
3level laminectomy,discectomy&PLIF L3-S1 02/20/04
6cages 8screws 2rods (oh my!) w/local bone graft
Success! Yay!

 
Old 10-26-2004, 08:12 AM   #13
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lfoster21 HB User
Wink Re: Incidental Finding

Carl, I am happy for you and also understand your uncertainty. Please let us know what the MRI says. Maybe we can help w/ your apprehensions. Remind me...has your ortho./neuro. looked at the MRI?


You're still in my prayers,

Lorie
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Old 10-27-2004, 12:40 AM   #14
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mlachowicz HB User
Re: Incidental Finding

Hey Carl

I'm pleased to hear that the Dr.'s are saying that there is nothing to worry about. Please post your MRI results!! I am sure everyone is curious.

The best place I have found information on the cyst situation is at spine health.
I tried posting the link, but didn't know I was not allowed.

I've got my 1st 'aquatic' pt apt tomorrow...
I went for follow up Xrays today -- waiting to hear from my surgeon.
~M~

Last edited by mlachowicz; 10-27-2004 at 12:45 AM.

 
Old 10-27-2004, 10:27 PM   #15
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standingman HB User
Re: Incidental Finding

Carl--This just a greeting from the ice flow. Not in this 'hood too often anymore, but always good to check in now and then. I think most of the cysts found are, indeed, incidental, and not significant in terms of symptoms or worries. Hang in, keep faith,

Swimmingman

 
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