Nimbus With surrounding marrow oedema, atypical Haemangioma. Should i be worried?

11-12-2017, 04:14 AM

Hello and Good Morning,

I am 28yr old (29 at the end of this month) Female not sure if this will have any direct link to anything but the more information i can provide im sure the more someone could help me.

So just a bit about the beginning ages about 16 i started having problems with my knees where my legs would just feel like jelly and my knee caps would just come out of place as time has got on things have gotten worse i was then diagnosed with Lateral Patella syndrome and i manage it the best i can.

I now have maralgia parasthetic (unsure of the spelling) down the right side of my thigh. i also feel as tho there is something wrong with my nerves in general. i find my muscles twitch for no reason at all and are quiet painful quiet often to the point that it affects my life in a huge way.

I noticed my back becoming increasingly more painful so i went to see my doctor who sent me for an MRI scan February of this year. I was under the illusion that it was fine and nothing was wrong after being told it was fine by my doctor. Recently ( a week or so ago) a senior nurse at my doctors was having a look over my files and trying to figure things out when she came across the letter from who ever did the checking of my MRI scans, she printed me a copy of the letter and the notes out but if im honest i really don't understand them at the bottom the the letter it says

" impression: appearances are of a benign lesion. differential diagnosis includes osteoid osteoma; presumably , the central focus may represent a nimbus with surrounding marrow oedema. alternatively, this may represent an atypical haemangioma recommended limited CT extending from L3-L5 for clarification and subsequent specialist referral. "

I have no clue what most of this means and im quiet angry that i was told everything was fine, when it says i think to send me for another MRI of L3-L5 and to send me to a specialist.

By any chance can any one explain what this means iv been struggling to have a decent life for over 10 years with things just getting increasingly worse. Im sorry its so long winded but i just wanted to put a little back ground in to what has been happening

i appreciate all of the help any of you guy an gals can give me

Thank You <3

11-13-2017, 06:41 PM

I could have sworn I wrote a reply to your post, but I don't see it...so can only assume I started it but didn't finish.

My best guess is that you don't need to be worried but If I were in your shoes, I would follow through on the radiologist's suggestion to have a new MRI focusing on L3-5. I would be interested in seeing what the rest of the report says to see if there are other issues that were thought to be unimportant.

When you are trying to find the source of pain, it is important to look at everything!

Regarding the finding, the only thing we can conclude is
that there is something unusual about the bone of the vertebra or perhaps something like a hemangioma near the vertebra. It might be what is called a limbus vertebra...which is something you can read about online...but basically it looks like a little bite out of the anterior side of the edge of the vertebra, or it can look like a little triangle added to the bone. It is thought to be caused by trauma. It has been reported to cause nerve compression or. lower back pain if it is located on the posterior edge. Otherwise it is considered an "incidental finding" and has no clinical significance. I assume that whoever told you everything was fine was making this assumption!

11-15-2017, 12:59 AM

ok, i will type out the whole thing but i have a feeling there will be SP so please forgive me haha!

MRI Spine lumbar & sacral
Sequences acuired : standard protocol + STIR Sagittal

Findings:
no prior images of the lumbar spine are available for comparison at time of reporting
lumbar lodosis is partly preserved

the vertabra are normal height and alignment. partial segmentation of T10-11 vertebral segments is noted. within L4 vertebral body subjacent to the superior endplate , a central lesion with well circumcised margins measuring approximately 1 cm in diameter demonstrates a target appearance and returns alternating hyperintense signal and hypointense ring on T2 and STIR. On T1, it is homogeneously hypointense. the endplate is intact posterior elements appear normal.
intervertebral discs appear normal no radicular compromise
the central canal is of normal dimensions
the distal cord appears normal and conus medullaris terminates at T12/L1 disc level within the soft tissues posterior to the spine extending from L2 to Upper L4 level. this is amorphous oedema

Impression:
appearances are of a benign lesion. differential diagnosis includes osteoid osteoma; presumably , the central focus may represent a nimbus with surrounding marrow oedema. alternatively, this may represent an atypical haemangioma recommended limited CT extending from L3-L5 for clarification and subsequent specialist referral

i honestly hope iv gotten that right... but this is all i have to go by at the moment..

im a bit fed up of all of it and have no clue what anything at all really means

thank you for your reply and help xo

11-16-2017, 04:24 AM

any ideas? :/

11-16-2017, 08:25 AM

Basically there isn't anything else of significance. All the important things are normal...most of the words you may not be familiar with refer to technical aspects of the type of scan (T1, T2, STIR) and lots of words refer to the location of the "nimbus."

1cm in diameter is small. There aren't any other changes in the vertebra. Alignment is good, the discs all look good. The central canal is open and the appropriate diameter. So, everything is perfectly normal except for this one small area which is benign. So, in a way, I can see why the doctor didn't feel this was worth mentioning.

11-16-2017, 08:33 AM

i dont understand why im getting so much pain then

could it be muscle related or would that also show up? and why do i need another MRI/referral?

11-16-2017, 09:12 AM

Where is your pain located? What specifically are your symptoms?

The radiologist suggested another more specific MRI because he couldn't say for sure what he was looking at...nimbus, hematoma, etc. He assumes it is "nothing" but wants to make sure.

Nimbus With surrounding marrow oedema, atypical Haemangioma. Should i be worried?

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