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    Old 02-02-2012, 02:54 PM   #1
    kadedoll
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    DR wants a brain MRI to look for MS?

    Pardon the long story. This is my first post, and I figured I'd post it in here since I"m having a MRI done Wednesday to "rule out" MS. I'm a 25 year old female. Here is my back story;

    About a month and a half ago, I stood up out of my car and experienced an intense upper right back pain and pressure on my right chest.. The pain lasted a few days and then the pain shifted until just my right upper back/shoulder/neck/in between my shoulder blades. I was having major spasms in my back that never seemed to stop. Primary treated me for muscle spasms, gave me Flexeril & Tramadol and prescribed PT. Symptoms continue to worsen & new symptoms arrived. Numbness/tingling/burning in my right arm/hand; Major pressure at the back of my head; neck pain; extreme nausea; dizziness; lightheaded; fogginess; some "buzzing" in my ears/head. As of the past few weeks, my legs feel like they're going ot give out all the time. The numbness/pain/tingling is also in my right leg. Balance has always been an issue for me as well as general clumsiness/ ie/ falling up stairs, tripping over my own feet..etc. I've also noticed a stuttering issue that started in my teens and seems to gradual get worse over time. I seem to .. not be able to get the words out even though they're in my head.

    I got an Ortho to order the MRI as requested by PT. MRI report started 8 broad-based disc bulges in lower back and cervical, 1 protrusion at c2-c3. degenerative discs as well. So I was referred to the "best" pain management / spine specialist in town. Saw him today. He told me the MRI didn't show any issues.. He brought it up in front of me. He said they usually "overwrite" the MRI reports. He says he wants to do a brain MRI to test for MS and also a MRI on the braciular artery.

    Obviously, when someone mentions a brain MRI, panic sets in. I thought I finally had an answer for my issues with the first MRI.. and he's saying otherwise. I have to trust his word, as he's the "best in town." The MRI was ordered without contrast. I guess now I'm worried about whether I should prepare mysel ffor the possiblity of MS or not. No one in my family has ever had MS that I know of. If it's not MS, what else could be going on since he's claiming the MRI report isn't true?

     
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    Old 02-02-2012, 04:47 PM   #2
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    Re: DR wants a brain MRI to look for MS?

    HI and welcome to healthboards...

    You are in a predicament, arent you? Lets start with the facts. First of all, no matter how "Good" a doctor you think you are seeing- you said he is a pain mangement/ spine guy...this does NOT qualify him to read a MRI or to order one to rule out MS. So, I wouldnt believe that what he told you, that there is no problems on your MRI is true. Next thing, hell be telling you he wants to send you to a neurosurgeon for surgery....do you have the MRI report? There is an area at the bottom of it, which is called the impression, if you read this to us, we can help you interpret it. If you dont have it, get it tomrorow. Stop by and ask for a copy. And, if you do NOT have the films - go whereever you went for the MRI and ask for a copy of them, too. Youre going to need them.

    Second, MS is not hereditary. No one in my family has it either...and MS lesions, which are attacks on the central nervous system, show up on either a Cspine or Brain MRI and can affect the eyes as well. Occasionally, those lesions also show up lower in the spine... a brain MRI is no scarier than the Cspine one which you had...however, without having had Contrast, your MRi isnt accurate for an MS test....also, whoever you told you have 8 broad based disc buldges in your lower back from your Cspoine MRI is either lying to you, or you heard it wrong. Nothing about your lower back will show up on a Cspine MRI...so where does this make any sense?

    You need a neurologist. Plain and simple, preferably one who is a MS specailist...they are the ONLY doctors qualified to read a MRI for MS diagnosis. Occasionally, you will find a general Neurologist who has a special interest in MS, and a large patient load of MS patients- they are out there (I have one) and they are also qualified to read the MRI; however if your general Neuro is a Parkinsons specialist, he is worthless to you....finding a MS specialist is sometimes a lenghty wait...they are few and far in between and can take months to see...however, if you call and beg, with an "emergecny" you sometimes get lucky....but you will need the films and report from your test so far.

    No pain managemnt specialist is qualified to rule out or dx MS. Sorry...but "your best in the town doc, isnt the right doctor for you. Since the Ortho guy referred you, Im wondering why you dont call the ortho doc and ask him for his opinion on why he thought you had all these issues, but the pain specialist doesnt agree. Id work backwards.

    Do you have MS? Could you have MS? Yes, but MS mimics 400 other diseases- every single one of your symtoms could be explained by slipped discs and herniations......or it could be 1 of 400 other things...you really need a MS specialist to A. order the right tests B. read the tests you have had so far and comment on them and C. diagnose or rule out MS.

    Sorrry, but a pain specialist doesnt cut it and whoever told you about your lower back, based on a Cspine MRI.....thats not even possible.
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    Old 02-02-2012, 05:00 PM   #3
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    Re: DR wants a brain MRI to look for MS?

    Quote:
    Originally Posted by MSNik View Post
    HI and welcome to healthboards...

    You are in a predicament, arent you? Lets start with the facts. First of all, no matter how "Good" a doctor you think you are seeing- you said he is a pain mangement/ spine guy...this does NOT qualify him to read a MRI or to order one to rule out MS. So, I wouldnt believe that what he told you, that there is no problems on your MRI is true. Next thing, hell be telling you he wants to send you to a neurosurgeon for surgery....do you have the MRI report? There is an area at the bottom of it, which is called the impression, if you read this to us, we can help you interpret it. If you dont have it, get it tomrorow. Stop by and ask for a copy. And, if you do NOT have the films - go whereever you went for the MRI and ask for a copy of them, too. Youre going to need them.

    Second, MS is not hereditary. No one in my family has it either...and MS lesions, which are attacks on the central nervous system, show up on either a Cspine or Brain MRI and can affect the eyes as well. Occasionally, those lesions also show up lower in the spine... a brain MRI is no scarier than the Cspine one which you had...however, without having had Contrast, your MRi isnt accurate for an MS test....also, whoever you told you have 8 broad based disc buldges in your lower back from your Cspoine MRI is either lying to you, or you heard it wrong. Nothing about your lower back will show up on a Cspine MRI...so where does this make any sense?

    You need a neurologist. Plain and simple, preferably one who is a MS specailist...they are the ONLY doctors qualified to read a MRI for MS diagnosis. Occasionally, you will find a general Neurologist who has a special interest in MS, and a large patient load of MS patients- they are out there (I have one) and they are also qualified to read the MRI; however if your general Neuro is a Parkinsons specialist, he is worthless to you....finding a MS specialist is sometimes a lenghty wait...they are few and far in between and can take months to see...however, if you call and beg, with an "emergecny" you sometimes get lucky....but you will need the films and report from your test so far.

    No pain managemnt specialist is qualified to rule out or dx MS. Sorry...but "your best in the town doc, isnt the right doctor for you. Since the Ortho guy referred you, Im wondering why you dont call the ortho doc and ask him for his opinion on why he thought you had all these issues, but the pain specialist doesnt agree. Id work backwards.

    Do you have MS? Could you have MS? Yes, but MS mimics 400 other diseases- every single one of your symtoms could be explained by slipped discs and herniations......or it could be 1 of 400 other things...you really need a MS specialist to A. order the right tests B. read the tests you have had so far and comment on them and C. diagnose or rule out MS.

    Sorrry, but a pain specialist doesnt cut it and whoever told you about your lower back, based on a Cspine MRI.....thats not even possible.
    Nikki


    My apologies. I have 4 broad-based disc bulges in my lumbar and 4 in my cervical. The ortho had ordered a cervical & lumbar MRI. Both showed issues with degerenative discs as well.

    Who should I go to in regards to the results of the original mri? The ortho read them and sent me to this "specialist" for pain management. So now I'm just as confused as before.

    the impression on the lumbar; mild denerative changes as most significant at l3-l4 and l4-5

    the bulges were at l2-l3, l3-l4, l4-l5, l5-s1. there was mild stenosis on all, and moderate on l3-l4


    cervical impression; degenerative chances, as above, most significant at c2-c3 and c3-c4.

    in the findings it also says; disc desiccation is noted at c2-c3 and c3-c4.

    c2-c3: central disk protrusion, mild central spinal without neural foraminal stenosis.

    then there are broad-based disk bulges at c3 through c7. with mild central spinal and right or left neural forminal stenosis on them.

    this is why i was confused with the doctor stating that they often 'overwrite' mri reports. I've never had any back/neck pain prior to these issues.. and to me, it makes sense that the c2-c3 protrusion would cause some of these symptoms including; dizziness, nausea, head pressure/pain.


    The other issue is that he gave me a 5 day pack of steroids to take, and I did read online that the steroids can interfere with the MRI results. The MRI is scheduled for Wednesday.

    He said he was concerned with the symptoms I'm experiencing at my age.. blahblah. I just feel lost with the change in answers and now a lack of answer at all.

     
    Old 02-02-2012, 05:48 PM   #4
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    Re: DR wants a brain MRI to look for MS?

    sorry if this posts more than once.. i'm not sure if my last response went through.

    also; i mistyped.. there are 4 broad based disc bulges in lumbar and 4 in cervical, plus the disc protrusion in c2-c3.

    Both of the "impressions" didn't say much on the mri results.. but the lumbar one stated "degenerative changes as above most significant at l3-l4 and l4-l5. The basis of the report for the lumbar stated broad-based disc bulges at l2 through s1. with mild to moderate central spinal stenosis and mild bilateral neural forminam stenosis

    cervical mri imipression: degenerative changes as above most significant at c2-c3 and c3-c4.

    the findings stated disc dessociation at c2-c3 and c3-c4.
    there is a central disc protrusion at c2-c3. mild cnetral spinal stenosis.

    then there is broad-based disc bulges from c3 to c7. mild central spinal on all and left greater than right neural fornimal stenosis on c3-c4.. and left neural forminal stenosis on c5-c6.


    I've been in PT for 3 weeks, no improvement or relief yet.

    That MRI was without contrast.. and the MRI he scheduled for Wednesday for my brain is also without contrast..

    I also read online that steroids can affect the result of a brain mri. he gave me a 5pack of steroids to start today

    Last edited by kadedoll; 02-02-2012 at 05:52 PM.

     
    Old 02-02-2012, 06:07 PM   #5
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    Re: DR wants a brain MRI to look for MS?

    Kadedoll.
    i must have misunderstood you because I could have sworn that you said you had a Cspine MRI (the first time) Im sorry. SO, your MRI suggests there is nothing really wrong with your spine. All the degeneration in the world can be from trauma, like a car accident, or normal from aging. Stenosis, is also a normal thing, if its mild. You dont have anything on your MRI reports which many many people also have...myself included. I have 3 compressed discs at C2-C3-C4 and I have herniations at C4-C-5. I get it, it causes alot of pain...

    You read that steroids can cause a bad MRI, you may have read that by me. I wrote it tonight...usually when we talk about steroids in the MS capacity, its 1000 mgs injected into a vein. Not a steroid pack; however I just did some research, any steroids can conflict a MRI....so, no its not something you can take for granted will be "just fine"...the fact that he is doing this without contrast again, also proves he isnt the correct doctor to be reading or ordering your tests.

    I go back to my original suggestion....find a NEurologist and start over. And, if you dont want to do that, have the tests and take them to a neurologist because there is no way that a pain specialist is qualified to say yes or no to you about MS.

    Sorry I misunderstood, but your MRI was ordered for an ortho eval, NOT a MS eval- therefore, you arent even getting the correct slices scanned in a way which would necessarily show MS....its possible, something could appear, but its also just as likely that nothing will. Sorry, but its all about the doctor when you are speaking MS.....if it makes you feel any better, your MRI proves that your pain and neuropathy (tingling/ numbness) could all be from your spine.....
    Nikki
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    Old 02-02-2012, 06:13 PM   #6
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    Re: DR wants a brain MRI to look for MS?

    Yeah, i typed everything fast, so it's possible i confused myself.

    The doctor is stating that my MRI is fine though.. apparently he doesn't agree with the mri report that the person wrote up..stating that they "overwrite." I still think the c2-c3 protrusion could be the cause of the majority of the issues.. I'm not sure that I believe that the brain MRI is necessary honestly. I know that he had also planned on referring me to a neuro for nerve testing.. so maybe he will take over the MRI results?

     
    Old 02-02-2012, 06:17 PM   #7
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    Re: DR wants a brain MRI to look for MS?

    When an MRI is ordered for the C-Spine it is not a large area. The upper part attaches to your brain (essentially) so a brain MRI would be necessary, I believe. If you were presenting neurological symptoms or the appearance thereof, a brain MRI would be necessary because it is the heart of your neurological system. The main trunk line goes through your C-Spine and then branches out.
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    Old 02-02-2012, 06:24 PM   #8
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    Re: DR wants a brain MRI to look for MS?

    YOU take the MRI results...no matter who refers you or what they say, you take your films and your reports and let the Neuro look at this. You may be in for an EMG ,which is a simple nerve conduction test that neurologists can give...but Jayhawk is right. A brain MRI cant hurt and is necessary to rule out alot of other things...
    YOU are also right....the Results conclusively show that there is reason for pain to be evident....I have the same type of pain and also did PT 4 x a week for 2 months without any relief..

    Get the test, see the Neuro...and find another doctor if it turns out NOT to be neurologic! And, worst case scenario- MS isnt fatal...most of us have it- all of us are highly functioning individuals- and we will worry about helping you through it if you have to face it...but Im willing to bet its not MS.... Back pain is wicked bad pain...have you considered dropping in on the back/ spine board here at healthboards? There are some really smart people who know more than we do about specifics of the spine- and possible relief for you. You might just want to check it out and say hello and hear what they have to say...but come back to us! We want to know how you are and how this turns out...
    Hugs and get some rest...stress and anxiety do NOT help!
    Nikki
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    Old 02-02-2012, 06:27 PM   #9
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    Re: DR wants a brain MRI to look for MS?

    Thanks so much! I wanted to try here to see if anyone knew of anything about "overwritten mris".. To be honest, I've been through a push and pull with doctors this whole time. The majority of them more or less made me feel as though I was "crazy" and my symptoms weren't really happening. Lol.

    Thanks so much for your help! I'll be sure to come back and let you know what the results are either way.

     
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