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Old 01-02-2012, 12:45 PM   #1
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MRI of Spine lumbar wo Contrast

In August I started having a quick "fluttering" feeling in my lower right front quandrant area with back pain and/or pain shooting into my female organ area. Dr. went from baldder/kidney infection to appendix to cyst on ovaries and finally decided perhaps it was a pinched nerve and sent me to PT. This helped but in November I had a gallbladder attack and had to have gallbladder removed, 4 days later a hernia broke through and wrapped around my small bowel - thus emergency surgery to repair. For 7 weeks I couldn't do the stretching the PT had recommended and my lower right pain/back pain intensified to include my right butt cheek and toes on right leg tingling off and on. I also swelled up at the opening to my bladder for no apparent reason in February of 2011. This happened again while all of this was going on and in addition I developed cysts that swelled on my Labia (mainly right side). Finally, Dr did an MRI and these were the findings:
A 5mm T1 and T2 hypointense, STIR (what does this mean - STIR?) hyperintense focal lesion within the L1 vertebral body in the left lateral aspect. A 4mm T1 and T2 hypointense lesion without STIR signal abnormality is seen the right lateral aspect of the L4 vertebral body. Additonal scattered T1 and T2 hyperintense signal foci in the L4 and L1 vertebral body are most consistent with hemangiomas. Remaining marrow signal is within normal limits.

There is also L1-L2: Right paracentral and foraminal disk protrusion. Narrowing of the right lateral recess. The disk abuts the traversing right L2 nerve root in the right lateral recess. No entral spinal canal stenosis. Mild right foraminal stenosis.
And
L3-L4: Mild hypertrophic degenerative changes of the facet joints with ligamentum flavum laxity. No central spinal caal stenosis. Mild bilateral neural foraminal narrowing.
And
L4-L5: Hypertrophic degenerative changes of the facet joints. Ligamentum flavum laxity. Mild central spinal canal stenosis. Moderate left and mild right neural foraminal narrowing.

Impression:
Right paracentral and foraminal disk protrusion at L1-L2 abuts the traversing right L2 nerve root in the right lateral recess.
Mild facet joint degenerative hypertrophic changes in the lower lumbar spine most marked at L4-L5.
Nonspecific T1 and T2 hypointense lesions withn the L1 and L4 vertebral bodies. These likely represent small bone islands given absence of findings on CT (I had a CT scan when emergency surgery for the hernia occured). Small focal metastatic lesions are not entirely excluded (I assume this is a "cover my own behind comment?).

My primary care dr said the only thing on the MRI to worry about is the bulging disks and sent me back to PT. Which is fine...however, after I spoke with my Dr. I began to read my MRI report and found the lesion part. This is bothering me and I'm wondering if I need to seek a neurologist to look this over. Is the information given just a normal degenerative thing - do most people have lesions on spine at my age or is this something I need further investigation on? I am 46 year old female, 5'4 weighing 150lbs. I haven't exercised regulary but am now! I eat fairly healthy. My parents both had clogged arteries but they also smoked and didn't take care of themselves. I have never smoked or done drugs and don't drink very much alcohol. There is no history of lesions or cancer in my family but my father had heart disease. My grandmother died of a rare disease called Olivopontocerebellar Atrophy which resembles MS. Thank you for any input.

 
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Old 01-03-2012, 11:25 AM   #2
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Re: MRI of Spine lumbar wo Contrast

Welcome to the board.

Don't worry about the STIR. It is just technical jargon for something they can do with MRI technology to make it easier to "see" at the cellular level. It stands for short-tau inversion recovery (STIR).

The lesions are something that should be noted on the radiology report, but is nothing to worry about.

The "bone island" is an area of benign cell growth of either bone or cartilage that shows up in the middle of a bone. It usually doesn't cause any pain and is only discovered when imaging is done for some other purpose. They can sometimes cause pain after strenuous exercise, especially when the bone island is in a long bone like the thigh. I would be surprised if it caused pain in a vertebra...but then, we members are not doctors, so surprise is always possible.

Your symptoms do make sense for someone with a disc bulge that is compressing the L2 traversing nerve root. If you want to see a general pattern of how the spinal nerve innervates a particular area, just look online for a dermatome map. You will see where the nerves for L1 and L2 go.

Hopefully with some PT and careful body mechanics and good posture, etc. you will be able to heal the disc herniation. If you continue to have issues, you will want to see a spine specialist for an accurate diagnosis for your back problems.

 
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Old 01-03-2012, 11:44 AM   #3
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Re: MRI of Spine lumbar wo Contrast

Saw PT this morning and feel so much better! Will be going to her 2 X's week for 3 weeks to learn daily exercises. Hopefully I won't have to get steroid shots or worse, back surgery.

 
Old 01-03-2012, 12:15 PM   #4
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Re: MRI of Spine lumbar wo Contrast

Excellent. Remember, assuming you can take NSAIDs, they are good to take along with PT...will help with whatever inflammation you may have going on inside the body. Also, don't forget about using ice when you are uncomfortable.

You can use ice or a cold gel pack 15-20 minutes per hour, being careful to protect the skin of course.

When you start feeling better, be sure to be aware of your structural alignment and body posture and body mechanics. Try to avoid excessive bending or twisting at the waist, and watch how you lift and how much weight you are lifting. If your disc heals, it will still be a bit weak, so it doesn't hurt to baby it for awhile.

Good luck!

 
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