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Old 05-24-2011, 11:42 AM   #1
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Angry I need help please! 2 MRI's, something isn't right...

I don't know how this can be, but I recently had a 2nd MRI done on 5/5/11. This was an (open) MRI of the lumbar spine without contrast, taken in the lying down position. The findings are as follows:

1) There is normal lumbar lordosis with no spondyloisthesis. The visualized
vertebral body bone marrow signal and disc spaces appear normal.

2) The conus medullaris is normal in position and appearance.

3) There is no significant disc bulge, protrusion, disc osteophyte bulge complex
or neural structure compromise throughout the lumbar spine.

4) There is no significant facet arthropathy.

Practically every day, I am in constant pain with my lower back, and more prominent pain is on my left side. The 1st MRI was done on 7/15/08 and the findings are as follows:

1) There is lower lumbar levoscoliosis. Vertebrae have normal height and
marrow signal.

2) L1-L4 Levels: shows no herniated nucleus pulposus or significant central
spinal canal stenosis. The neural foramina appear essentially patent.

3) L4-L5 Level: Facet arthropathy is noted bilaterally.

4) L5-S1 Level: Disc bulge incompletely effaces ventral epidural fat. Facet
arthropathy is noted bilaterally.

The conus medullaris and paraspinal tissues appear unremarkable.

I phoned the office of the 2nd MRI (a completely different radiology place from where I had the first one done) and explained my issues with the office manager. My issues being, how can I still be in pain, and 3 years later, have NOTHING showing up on their MRI. She had the radiologist re-read the films, along with comparing my MRI films from 2008 and he is standing by his original finding: NOTHING WRONG. I am awaiting her phone call, because she is having a 2nd radiologist at her office, review the films. What should I do if he/she comes back with the same thing, nothing wrong? Somewhere/somebody has messed up and misread the films. I honestly don't believe that nobody will own up to reading something wrong. Is there any other test, besides an MRI that will show scar tissue, or anything that I can do to find out why I am still having pain? I just want to get to the bottom of my pain, and start enjoying my children, as well as my life, once again. I know my body and know that something isn't right. (Just like I knew that when I had my day surgery/laperoscopy, that I would NOT be going home that day, and that something major was wrong!) I know that I am not crazy, and it drives me nuts that NOBODY wants to admit a mistake. I appreciate ANY help. Sorry this is long, but I condensed it down, as much as I possibly could.

 
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Old 05-24-2011, 11:57 AM   #2
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Re: I need help please! 2 MRI's, something isn't right...

Get the films yourself and take them to your doctor, preferably an orthopedist with lots of back expertise. (The whole films, not just the report.) MRIs get misread all the time, reading them is a very subtle process. Your doctor, with your symptoms and history in front of him, might be better equipped to read the film than a radiologist who doesn't know you from Adam.

A few months ago, I fell and hurt my knee. Got an x-ray at the hospital, they said it was fine. Went to an orthopedist, who took his own x-ray and found a small fracture. It was subtle and hard to see, but he found it immediately, because he also examined ME. Because the faint irregularity on the film was in the EXACT spot where I had the most pain and bruising, he could tell it was probably a real fracture.

The other possibility is that they mixed up your film with someone else's, which is unlikely but tough to rule out for sure.

 
Old 05-24-2011, 03:41 PM   #3
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Re: I need help please! 2 MRI's, something isn't right...

Yes, MRIs get missread all the time. Show one MRI to ten experts and you will get some differences from each. Xrays and scans do get mixed up at times, that and DNA, but mostly on "The young and the restless" and others of that ilk! Now, If I had a MRI done on my spine it would show facet arthritis, many degenerated discs, spikes of bone into my spinal chord, stenosis and more. I rarely get any pain and have full spinal movements. An MRI should never be looked at until after an examination is completed and a diagnosis is confirmed. The truth is that often the diagnosis is DDD or facet or something which means they are not quite sure but you have to tell the patient something.
Failed back surgery is not often failed back surgery but a failure to get the right level, it may be the level that was worst looking on a scan was not the culprit. The cure for that is do multiple levels of course and you cant miss. How long have you had this condition and what real treatment have you had.
James

 
Old 05-24-2011, 04:16 PM   #4
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Re: I need help please! 2 MRI's, something isn't right...

Hi there dont no if this will help but here goes I have had 3 back operations 4 mri scans and 3 ct scans various other injections and procedures.One thing I have learned is different doctors have different opions just like car machinics.It may well be they cant see anything on your scans but this does not mean your pain or problem is not real, that is one of the mistorys of back problems as my last mri showed my fusion is solid and the rest of my back is in good condtion,but that was 3 years ago and I live in terrible pain evry day I am still searching for answers.I would sugest you find the best spinal surgeon you can and get him to look at your mri,he may see something others have missed as they often do miss things in my experiance.Best of luck I know how you feel.

 
Old 05-24-2011, 05:20 PM   #5
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Re: I need help please! 2 MRI's, something isn't right...

Fighton,
Thank you so much for replying back to me. I am just aggrivated, that two radiologists, from the same place, (naturally) are going to agree with each other. It kind of reminds me of cops, and that "thin blue line". I am definitely going to ask my doctor for a 2nd opinion, and a 3rd if need be! I know that something just isn't right. I would even be (somewhat) to hear that my back is fine, and it IS JUST scar tissue. At least this way, there would be a logical reason for me to hurt. Thanks again, and also....good luck to you!

 
Old 05-24-2011, 08:33 PM   #6
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Re: I need help please! 2 MRI's, something isn't right...

[QUOTE=Chardaba;4762276]Fighton,
Thank you so much for replying back to me. I am just aggrivated, that two radiologists, from the same place, (naturally) are going to agree with each other. It kind of reminds me of cops, and that "thin blue line". I am definitely going to ask my doctor for a 2nd opinion, and a 3rd if need be! I know that something just isn't right. I would even be (somewhat) to hear that my back is fine, and it IS JUST scar tissue. At least this way, there would be a logical reason for me to hurt. Thanks again, and also....good luck to you![/QUOTE]

You I suspect have chronic pain like many more. That in effect means that the pain is now in the pathways of the brain and unless you receive the correct treatment, not more opinions and scans, the pain will remain and possibly worsen. As fighton says your scan shows a normal spine but that certainly does not mean your pain is not real. Since the advent of modern scans the folks with chronic pain has rocketed in America. In countries with the very basic facilities chronic spinal pain is virtually unknown. Get your doc to get you to a pain clinic.
James

Last edited by james079; 05-24-2011 at 08:34 PM. Reason: bad spelling yet again.

 
Old 05-25-2011, 01:55 AM   #7
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Re: I need help please! 2 MRI's, something isn't right...

JaneWhite1 & James079,
Thank you both for responding to me! For whatever strange reason, when thanked Fighton earlier, I wasn't able to see your posts.

James,
I have not had any treatment whatsoever, except pain management. I am deathly afraid of surgery and I realize that pain management only masks the pain, but for now, it works. If not for my meds, I would not be able to go and do things with my children. The office manager from the 2nd radiology office called me this morning. She had another radiologist look over both sets of films, and (of course) he's standing behind his co-worker's findings. I am going to see what happens when I go for my next pain management appointment in the beginning of June and see what he says. I am praying that he won't just drop me, without offering some sort of weaning off of my pain meds. I've been on strong meds for 3 years now and I can't just stop taking them. I am going to let him know that I want another (expert) opinion. Do any of you know what kind of test(s) (if there are any) that can pick up/show scar tissue? Maybe I also need to go that route too.

Again, thank you all for your responses. I greatly appreciate them all!

 
Old 05-25-2011, 09:06 AM   #8
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Re: I need help please! 2 MRI's, something isn't right...

I agree with thw above posts, I had cervical fusion on 3 vertabrae ,I had mri's ,scans,xrays, milagrams ,and every possible test that my insurance would pay for ,
I saw about 5 different orthopedic surgeons ony 2 of them had the opinion that I needed surgery, one even said after looking at the films that all I had was a little arthitis in my back, It was when I saw a surgeon that specialized in the spine and surrounding tissues did iI get better treatment, he went further than the other and sent me to another specialist that gave me nerve studies that got to the route of my problems
then he saw the source of my pain whereas the others didnot, goodluck

 
Old 05-25-2011, 01:38 PM   #9
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Re: I need help please! 2 MRI's, something isn't right...

Thank you Capatga. I will keep this in mind when I go to my next doctor's appointment in the beginning of June.

 
Old 05-25-2011, 09:53 PM   #10
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Re: I need help please! 2 MRI's, something isn't right...

Basically, your first MRI says there there is a little facet arthritis in the lumbar spine and a slight disc bulge.
There is no nerve root impingement which is good news! Even the discs seem to be in good condition
Your current MRI is also good news. It may be that the facets ( which are bone and aren't imaged as well on MRI as they are on CT scan, have worsened some and that arthritis has made them more painful, but as far as any disc bulges or nerve root compression goes, spinal canal stenosis, or herniations, there isn't any of that either.
You could ask about a CT scan if your doctor feels it is warranted so see if the arthritis may have worsened to see if that is what is causing your pain, but it may be that the pain you are experiencing is coming from the muscles, rather than the bony material or stenosis of any of the nerves and spinal canal.
If that is the case, some muscle relaxers and maybe some anti inflammatories might be of more help and possibly some stronger pain medications for flare ups if he thinks that might be necessary. There are also injections that might ease inflammation to help as well. PT might help if it is muscular.
The good news , at least right now, is that surgery doesn't sound like it will be something that you need to consider. And that is always good news.
As to why you can get entirely different reads on MRI's studies happens for many different reasons- the biggest one in your case is the time frame from one MRI to the next. In the majority of cases, disc bulges, even when they become worsen and become herniations will resolve in their own in about two years.Herniations for the most part will also resolve themselves in two years or a bit more...disc bulges can be positional- which simply means that if you are laying a certain way one time and not exactly the same way the second, you will get a different read than you did on the first report. A disc bulge can be a tiny little outpouching of the disc , rather than a true bulge but because of terminology use, can be called something that it truly isn't. Different radiologists can read a study and interpret it in a slightly different way.You said that you had a second radiologist re- read both studies and he agrees with the read on the 2nd MRI, again really good news..

 
Old 05-25-2011, 11:49 PM   #11
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Re: I need help please! 2 MRI's, something isn't right...

Chardaba,

Could you better explain where exactly your pain is? You just mentioned it's on the left side, but that doesn't tell us very much. Is it on the left side at the top of your buttocks or just barely to the left side of your spine? Is it down low in your spine or in the middle or your back? Do you also have pain down your leg(s) or is it only in the back?

If your pain is on the left side near the top of your buttocks, there is a condition knows as sacroiliac joint dysfunction (SIJD). It won't show up on lumbar MRI's, and can be diagnosed by a pelvic CT scan and SI joint injection, along with a clinical examination by a well-trained orthopedic surgeon who has had specialized training in the SI joint (who are few and far between unfortunately).

I just wanted to throw this out as a possibility as most people with this condition go years before getting a solid diagnosis and treatment. This happened to me. One of the biggest symptoms of SIJD is difficulty sitting due to pain.

I sincerely hope you get some answers soon.

 
Old 05-26-2011, 11:13 AM   #12
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Re: I need help please! 2 MRI's, something isn't right...

[QUOTE=Chardaba;4762276]Fighton,
Thank you so much for replying back to me. I am just aggrivated, that two radiologists, from the same place, (naturally) are going to agree with each other. It kind of reminds me of cops, and that "thin blue line". I am definitely going to ask my doctor for a 2nd opinion, and a 3rd if need be! I know that something just isn't right. I would even be (somewhat) to hear that my back is fine, and it IS JUST scar tissue. At least this way, there would be a logical reason for me to hurt. Thanks again, and also....good luck to you![/QUOTE]

You say,"Two radiologists, from the same place,(naturally) are going to agree with each other".That is just not true. Radiologists disagree over results at times, it is not an exact science. They would be very poor doctors indeed to agree on something for the sake of it.
James

 
Old 05-26-2011, 12:09 PM   #13
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Smile Re: I need help please! 2 MRI's, something isn't right...

BackHurtz, TwoHands, and James,
Thank you all very much. All of the feedback/responses that I've received on here have been very informing and helpful. I appreciate that!

As for the location of my pain. It's on my lower (lumbar) area of my back. It's positioned more towards my outer side (not nearer the spine) and is between my rib cage, and my waist. My aunt is a licensed massage therapist, and her massages have helped a great deal, I can get 2, maybe 3 days of relief with her help. I am thinking that, due to my previous surgeries, it might be a lot of scar tissue because (this may sound strange) when I can somewhat stretch my left leg, and side out, it offers a bit of relief. After my upcoming doctor's appointment, I will post with any information/responses that he gives me and we can go from there. I do have another question; will scar tissue show up on a CT Scan? Thanks again!

 
Old 05-26-2011, 08:01 PM   #14
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Re: I need help please! 2 MRI's, something isn't right...

It is not at all strange for stretching the leg to relieve back pain. "Generic" back pain is actually caused by spasmed muscles, and people with disc problems or spinal injuries or something usually develop muscle spasms as a consequence of the injury.

Stretching the hamstring, hips, sides, etc will relieve the spasm and help the pain, assuming you can stretch without aggravating any underlying problems.

Hasn't your doctor ever sent your to physical therapy to learn this stuff?

 
Old 05-26-2011, 08:43 PM   #15
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Re: I need help please! 2 MRI's, something isn't right...

It is possible to see scar tissue on MRI.

 
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