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Old 02-21-2012, 01:32 AM   #1
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lumbar mri ,can someone please tell me what this all means

Hi I have been having lots of back pain for 9 months ,I am on flexeril,mobic,and use vultaren gel..
I recently had an mri and doc says don't worry about results that everything is just normal for old age.And that none of this should be causing me any pain.I am only 44.I will put results here exactly as the report shows.Thank you in advance.

There is minimal retrolisthesis at l3-l4
There is mild ventral wedging of the t12 and i1 vertebral bodies in which appears chronic.There are herniated schmorls nodes within the endplates at all levels from t11-l5with mild associated degenerative reacted endplate changes.There are small anterior osteophytesat multiple levels.

There is a 6mm round t1 and t2 hyperintense marrow lesion within the l5 vertrebral body compatable with a focal hemangioma.

Within the l1 vertrebral body there is a focal round marrow lesion that measures 6mm in diameter.This demonstrates hyperintense t2signal.

There is defuse loss f t2 signal thruout the discs at all levels from t11-t12 through l3-l4compatable with difuse disc desicattion.no signal abnormalities are demonstrated within the region of the conus medullaris which extends to the l1-l2 level

FRom l1-l2 through l5-s1 there is a facet and posterior element hypertrohy.There is mild fluid within the facet joints at multiple levels.

There is fatty infiltration of the posterior paraspinal muscles from l4 through the visualizec upper sacrum.

Limited partial visualization of the upper pelvis demonstrates an anteverted uterus,There is a heterogeneous sinal within the visualized portions within the uterus with a suspected large mass within the fundus.

Can someon please tell me in plain words what all this means and if this could be causing my pain .thank you

 
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Old 02-21-2012, 10:01 AM   #2
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Re: lumbar mri ,can someone please tell me what this all means

You might want to post this on the Back Problems board...great person there who is able to tell you what this says in plain English. I'm good at explaining neck problems but just learning about backs.

Jenny

 
Old 02-21-2012, 10:02 AM   #3
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Re: lumbar mri ,can someone please tell me what this all means

ok thanks i have been trying to post it their all morning for some reason it will not post...

 
Old 02-21-2012, 07:13 PM   #4
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Re: lumbar mri ,can someone please tell me what this all means

Welcome to the board. I can't figure out why you couldn't get this to post on the back board. That is where we lumbar spineys normally hang out, but Jenny alerted me to your request for an "interpretation."

Of course none of us have formal medical training, so keep that in mind as you read. We can give you a general idea of the language in your report, but it is just one piece of the diagnostic puzzle. It is up to the doctor to flesh out the information found in the report with what is found on physical and neurological exam.

First, I suspect the doctor who gave you the results was a PCP or family doctor rather than a spine specialist. Would that be correct?

Could you describe your back pain -- where it is located, does it extend to a leg, what makes it better or worse, how much of the day or night do you have it, etc.?

Rather than continue taking pain medications and believing nothing is wrong, I would strongly suggest you make an appointment with a spine specialist. This would be a neurosurgeon or an orthopedic spine surgeon who limit their practice to issues of the neck and back. Despite the word "surgeon" in the name of their specialties, these are the doctors with the specialized education to give you an accurate diagnosis and a plan of treatment. They will always try all conservative measures first, and only if they fail will any sort of surgery be contemplated or suggested.

I'm sure you were shocked to be told your problems were a result of aging. What the doctor was trying to tell you is that the changes reported on your MRI are fairly typical for someone in your age group. Unfortunately, degenerative aging in the human spine begins in the twenties. For many the degenerative changes do not produce any symptoms, but for those less fortunate, problems arise, some of which cause pain.

Your MRI report has some things mentioned that are not common ailments. I do not feel comfortable trying to tell you what I think is wrong. I urge you to make an appointment with a spine specialist. Get a copy of your MRI if you have not already done so and take it with you to the first appointment.

I don't think the spine specialist is going to tell you anything much different from the other doctor, but since most of your issues are of a degenerative nature, I think it is wise to start with a spine specialist now rather than later when you may really need one.

The good thing about lumbar issues is that they almost never result in a medical emergency. Even though the patient may be in lots of pain, in most cases nothing is being further damaged by waiting to see a specialist, etc. The one exception to this generalization is when a patient suddenly develops bladder or bowel issues (such as loss of control). This is considered a medical emergency and the patient should call her doctor ASAP or go directly to an emergency room.

The other part of your MRI report that is something I do not feel comfortable commenting on is the following:

Limited partial visualization of the upper pelvis demonstrates an anteverted uterus,There is a heterogeneous sinal within the visualized portions within the uterus with a suspected large mass within the fundus.


Anteverted means the pelvis is tipped forward, which is not necessarily a problem. Sometimes back pain causes a patient to change her gait and structural alignment and posture is changed as a result. But the part the bothers me is the "suspected large mass" within the fundus (which is the top part of the pelvis, opposite the cervix. I do not know if this is anything significant, or not...but I would want to ask a doctor about it.

Now to the rest of your report....I'm just curious if you had the MRI at a place that does a lot of spinal work. The language in the report is less specific than what we usually see, and sme things are oddly worded. It isn't a big deal...I was just curious. Did you copy the report verbatim?

Anyway -- sorry this is so disjointed. I meant to write earlier today when I was home alone! Now I have people talking to and at me and I keep getting interrupted....

Most of the issues mentioned are indicative of degeneration which can take several forms, and also what we laymen would think of as "arthritis." I can go through and explain all the terms to you but what I cannot do is tell you if when taken all together these add up to something going on, like a specific type of inflammatory arthritis, or ? Individually the terms do not send up any red flags, but you have a number of things and I just don't feel comfortable trying to say what they mean al together.

There are several problem areas within a couple vertebrae and also several facet joints show changes. It is somewhat unusual to have the ventral wedging of two vertebral bodies which the radiologist suspects is chronic.
There are Schmorl's nodes at several levels. Schmorl's nodes look like little bites have been taken out of the endplate of the vertebra (which would normally look smooth). Generally they are asymptomatic and of little consequence. Most people end up having at least one.

Thoughout the lumbar area there are some mild problems with the facet joints. These are the small synovial joints that flank the spinal column and give us the ability to bend and twist. They are subject to the same arthritic changes that we suffer in other synovial joints in the body like the knee and ankle...sometimes extra fluid settles there and the joint enlarges. The report also mentions the development of some osteophytes which are bony overgrowths similar to bone spurs.

There are signs of disc dessication in the lumbar discs from the last thoracic disc to the L3-4 level. This means the discs are in the process of drying out. When this happens, the vertebrae can end up without any cushioning between them...which can be a source of pain...but, yours aren't there yet.

So to summarize, you have a lot going on, indicative of degeneration but nothing is "bad." It would be hard to pick something out and say "this is the source of your pain." Everything should be watched as the degenerative process may continue and things could turn more severe...but for now, all changes are mild...and I am guessing it is for this reason, the doctor told you that not much was going on....However, if you are in pain, I would see a spine specialist for a proper diagnosis....and a plan of treatment.

Again I apologize for how disorganized this is! I should just wait and rewrite it tomorrow, but I assume you are eager for some response, so this will give you something to mull over....I'll take another look tomorrow and see if anything else pops out!

 
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