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Old 01-18-2005, 09:03 AM   #1
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**MRI RESULTS** Comments Please? THANKS!

I was the one that posted below "New to...(below)"


Hey, I had my MRI last Wednesday after asking my CHIRO to move it up and not wait another two months. Here are the results summarized: This was done of the LUMBAR Spine and Sacroilic Joints only.

Alignment is normal. There is loss of disk signal and minimal loss of disk height at the L4-5 level with ventral extradural impression seen here. The other interspaces are well maintained. The formina appear widely patent on the sagittal views.

L3-4 - Axial images show normal caliber spinal canal, thecal sac, formina, and normal disk. Facets are midly hypertrophic here. (which means arthritic).

L4-5 - Axials show mild/moderate concentric disk bulging with a superimposed midline poterior disk protrusion, associated with some focal subannular signal; compatable with partial annular tear. This disk bulge does indent the central thecal sac slightly, but AP thecal diameter remains normal at 12 mm. The foramina are well patent here and no direct neural encroachment is confirmed. This could very well be a source of low back pain, but probably not radicular symptoms. Facets are mildly hypertrophic at this level (again, arthritic).

L5-S1 - Axials show normal spinal canal, thecal sac, foramina, and normal disk. Moderate hypertrophic facet arthropathyis present here (arthritic). This could also be a source of back pain.

Images of the sacroiliac joints show no clear erosive or cystic changes and no significant hyperostosis of the SI joints. There is a small lipoma in the right sacral ala.

1. Could this LIPOMA be causing all the pain in my right side hip, leg and ankle?

2. Arthritis?? I'm only 35 years old and this was only my lumbar spine? What about the rest of my spine, I'd bet it'll show the same!

3. He is referring me to a specialist in the spine. Do you think I'll need surgery?

Thanks!

Sandra
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Old 01-18-2005, 10:21 AM   #2
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Re: **MRI RESULTS** Comments Please? THANKS!

1) I have several lipomas. I was told, "if they cause you any discomfort, take them out, if not, leave them alone". I have since studied them and have gone to see a plastic surgeon. Twice now I have put off taking them out due to the possibility of the dreaded, scar tissue issue. They wouldn't cause any pain involving a nerve unless the MRI showed it pressing on a nerve. I would have a second look with a CT scan if it still bothers you and set up a consult with a plastic surgeon. Lipomas are pockets of fluid that build up to protect a joint that is irritated. They can be sucked out with a needle or if they have hardened, taken out in an in office procedure.

2) After the age of 30, pretty much everyone has some degree of arthritis somewhere in their body.

3) You are being referred to a spine specialist because this is what docs do, they refer out. Everyone is specializing these days.

Surgery, not unless it is the last resort and right now your MRI doesn't seem to indicate surgery. You might be sent for more tests.

When one is in pain, one tends to react and want answers. I know that I have been seeking concrete answers for almost two years. You just have to keep following the trail of docs until one of them figures it out.

What about PT? That is the first line of defense in back pain.

take care,

 
Old 01-19-2005, 03:44 PM   #3
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Re: **MRI RESULTS** Comments Please? THANKS!

[QUOTE=injured betty]1)Lipomas are pockets of fluid that build up to protect a joint that is irritated.,
[/QUOTE]


A lipoma is a fatty tumor.

 
Old 01-19-2005, 06:28 PM   #4
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Re: **MRI RESULTS** Comments Please? THANKS!

I guess that every doctor has a different definition for them. I have been to several and all of them have a different twist on them. They were first diagnosed as synovial cysts. So, I looked that up. Pockets of synovial fluid that build up after an injury to protect the joint. I was okay with that.

Next doctor, who I went to to remove them, sorry, yours are not fluid, yours are more set, hard, can't take them out with a needle as planned. So, I said, what are they then? He said, "Oh, they are lipomas, same as synovial cysts, yours are just a bit different". Confused, yet, cause I was.

So, I went back to the original doctor who diagnosed them. He said that they come in all shapes, sizes, and are not always fluid. He had no set answer as to why they exist.

He never said the word tumor, I think because another doctor's data entry person has already typed in limphoma and freaked me out. Total mistake on her part.

Anyway, *fatty tumor* is pretty generic. All lipomas are not the same. Some can be removed and should be, some dont' need to be. Some can be removed by a doctor during a routine visit, some sucked out with a needle, some it takes a knife.

If I were you, I would ask for a more definitive answer.

take care,

 
Old 01-19-2005, 08:05 PM   #5
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Re: **MRI RESULTS** Comments Please? THANKS!

He never said the word tumor, I think because another doctor's data entry person has already typed in limphoma and freaked me out. Total mistake on her part.

Anyway, *fatty tumor* is pretty generic. All lipomas are not the same. Some can be removed and should be, some dont' need to be. Some can be removed by a doctor during a routine visit, some sucked out with a needle, some it takes a knife.

I [/QUOTE]

Actually they are either surgically excised or they can be removed by liposuction. Unfortunately a needle won't do it since they aren't fluid. You are right though, they don't always have to be removed if they aren't bothersome. They can become malignant in very rare cases. This I remember reading in the Merck Manual. I had one removed because it kept getting larger. Sometimes they are only a small subcutaneous nodules and other times they can get quite large. Mostly they are just harmless.

Bobi

 
Old 01-20-2005, 12:02 PM   #6
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Re: **MRI RESULTS** Comments Please? THANKS!

[COLOR=Magenta]I [/QUOTE]

Actually they are either surgically excised or they can be removed by liposuction. Unfortunately a needle won't do it since they aren't fluid. You are right though, they don't always have to be removed if they aren't bothersome. They can become malignant in very rare cases. This I remember reading in the Merck Manual. I had one removed because it kept getting larger. Sometimes they are only a small subcutaneous nodules and other times they can get quite large. Mostly they are just harmless.

Bobi[/COLOR]

Bobi: This is why it all gets so confusing.

I have been chasing this problem for about two years. I have seen two DOs one plastic surgeon, a spine specialist, a Neuro and an MD. Everyone of them see and feel the same thing on my back. Each of them have different words for them beyond the word, lipoma. I have had them want to take them out with a needle, remove them with a knife and some who want to leave them alone unless they bother me, which they do.

The doc who diagnosed them said that they should be left alone unless they bother me. The DO said that they should come out. The second DO set up an appointment with the plastic surgeron. The plastic surgeon asked for MRI's. He thinks that they should come out. The MD said to take them out, but he did not do that kind of thing. The spine specialist set up an appoinment to take them out but then said that they weren't fluid, most are, and that he was planning on taking them out with a needle, but the were solid. Back to the plastic surgeon. He said that they started out as fluid, from my injury, sacs of synovial fluid, but had hardened as I healed. That did not make sense to me as I have not healed.

The PT called them *back mice* and said that he could find them on any one that he worked on. He called them, as you did, fatty tumors.

I only wish that I could get a definite diagnoses. I guess that I will once I have them removed. The MD gave me a ludicrous story about how he had already removed them from the very area mine were in because the women were horse back riders and they bothered them when riding. What are the chances of two women in our area having the same exact problem, let alone, three?

I am not disagreeing with your statements. I think that the doctors use it for a catch all. Do I have lipomas in my back? Do I have synovial cysts? Who knows for sure. I am not even sure, at this point, what the difference except that I have been diagnosed with both in the same exact spot. It was the Neuro who diagnosed it as synovial cysts/lipomas. But then he may be wrong. At this point I am not sure who to believe.

So, isn't liposuction performed with a huge needle like instrument? I have never had it done but have watched it on tv.

Clarification please?


 
Old 01-20-2005, 12:19 PM   #7
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Re: **MRI RESULTS** Comments Please? THANKS!

[QUOTE=injured betty][COLOR=Magenta]I [/QUOTE]

So, isn't liposuction performed with a huge needle like instrument? I have never had it done but have watched it on tv.

Clarification please?

[/QUOTE]


It is performed using a cannula (decent size plastic tube) that they insert into the fat and suction it out. The most common places for lipomas to occur are on the nape of the neck, the trunk and the forearm. That's not to say they can't occur elsewhere. Most lipomas are surgically removed though.

Bobi

 
Old 01-20-2005, 01:00 PM   #8
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Re: **MRI RESULTS** Comments Please? THANKS!

Okay, bobby that was a more than I needed to picture, situation. Thanks for the info then.

Mine (well three or four of them) are located mid back, SI joint (not be be confused with the S1 joint), and over the dimple of my butt.

I was doing some reading and found out that all of the doctors might be correct. I am thinking that the Neuro might be referring to the synovial cyst that appears in my MRI, which can't be felt and the others are referring to the ones that can be felt.

So, do I have the surgeon remove the synovial cyst and which one, the plastic surgeon, the Nuero, or the Spine Specialist? How about the lipoma?

Again, back to a confused state of mind.

 
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