Mri help

03-19-2015, 12:19 PM

I have had a lot of back pain in my life. When I was 12 I was in an accident that broke the vertebral body of T12, and the transverse process of T11. That accident was in 1997. I received no medical treatment whatsoever. I'm not sure if my parents didn't understand the dr (language barrier) or what happened. I would hate to believe that they just didn't care, but sadly, they are both deceased, so I can't ask my question to them. I recently only found out about the spinal breaks, when I was looking into my medical records. In 2009 I had saddle numbness and pain in my legs and numbness in my toes. MRI revealed an annular tear at L5S1 disc with protrusion. I did the therapy, and exercises. Never really found much relief. I have been very stiff, and unable to bend as of late. The pain has been UNREAL!!! I had another MRI on 3-16-15. I received a disk when I left the office. The report has been sitting on my drs desk since Tuesday. The nurses have tried to explain the findings to me, but it truly is over my head. I understand that the disc at L5S1 has completely degenerated at this point. The nurse also said something about foramen stenosis (NOT QUITE SURE ON THAT ONE). What has me concerned at this point is this... like a dummy, I looked at the disc with the MRI images. The saggital view with a T2 Weight has a very large white splotch almost covering half of my vertebral body at L5. The same view, but T1 weight has the same splotch but it is black. In the coronal view of the lumbar spine, the vertebrae looks completely cracked through the center of the vertebrae. The nurses haven't found anything describing this in the report. Could it be normal? Do radiologist miss things like this? I understand without looking at the images its hard for anyone here to say, but is it out of the question to have a second opinion from another radiologist? Thanks in advance for any help. P.S. My doctor is a good dr, but his partner upped and quit last week, so my dr has been trying to juggle all of his patients and his former partners patients. I'm trying to be patient, but I'm scared I'm going to get swept under the rug in all of the chaos going on at the clinic.

03-20-2015, 12:02 AM

Are you being seen by a spine specialist Dr? That is a neurosurgeon or orthopedic surgeon with specialized training in the spine that limits their practice to only spinal issues. Even though these Drs are surgeons, they are also skilled at evaluating non-surgery requiring spinal conditions. If not, I would think that would be the first order of business. They will read your MRIs themselves along with clinical assessment to determine the course of treatment. It sometimes takes a while to see a good one so I'd start as soon as possible if you are not already seeing one.

Foraminal stenosis is what I assume the nurse meant. It means that the area for the nerve roots exiting between your L5 and S1 vertebrae has narrowed, probably either do to a disk herniation, or arthritic bone spur or both. This can cause things like numbness in your toes and leg pain.

If there is indeed a big white splotch on the T2 image in the vertebral body that is associated most commonly with hemangioma (benign vascular tumor). It could also be related to your previous injury where the vertebrae just didn't heal correctly and therefore aren't the same density as the surrounding bone. Occasionally you see image artifact as well but that is less likely to show up in other sequences like T1. It is odd that the radiologist doesn't mention it, as they will usually note things like image artifact and hemangioma even though they most often do not have any significance in terms of symptoms. I think asking the at the office where you had the MRI for a clarification from the radiologist should be possible. A spine specialist could also help with interpretation as well.

Good luck with you appointments and let us know how they go...

03-22-2015, 12:21 AM

I have an appointment with a neuro/spinal surgeon. I actually called the MRI office, and asked the radiologist on call what the policy was on transcribing the reports. She said that if it was pertinent to your referral, then it would be put in the report. She got snippy a couple times as well. She kept saying that she cant diagnose me over the phone. I just kept telling her that I didn't need to know what the huge white spots were, but I did want to know if normal findings were left out of the radiologists report. By this logic, if the spots were normal, then I could just rest easy since they weren't put in the report. Anyway, my best friend used to work for an orthopedic surgeon. She isn't employed there anymore, but she is great friends with the head surgeon and radiologist. She is going to take my disc over there, and have them look at it. She is worried because in her 10 years of orthopedic work she has never seen anything like the white spots on my mri that wasn't a tumor. She said that most of the time they aren't cancerous, so that's a HUGE plus! Thank you for your reply.

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