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  • MRI Results-please assist in layman terms

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    Old 03-08-2009, 05:05 AM   #1
    Calflady
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    Question MRI Results-please assist in layman terms

    think I need an expert here please to assist me with interpreting my MRI results. I basically slipped in a very long shower pulling my head up so not to crack it open and landed on my back with my leg in a weird position. Of course I put my arms behind me to break my fall-bad mistake.
    I have just got plaster off as they said I had fractured the scaphoid and thought pinning may be needed however upon MRI results he took it off? I might add that I get weakness in both arms numbness and tingling in my fingers. Weakness to the elbows, dropping things and sometimes just unable to hold something.
    MRI
    RIGHT WRIST
    There is minimally displaced fracture through the distal radial metaphysis. Position is satisfactory in cast. Fine detail of the carpal bones is obscured by the overlying cast. This is when he took the cast off.
    MRI LEFT SHOULDER
    TECHNIQUE:
    Axial and sagittal PD with fat sat. Sagittal and coronal T1. Coronal T2 with fat sat.
    FINDINGS
    There is a partial thickness undersurface tear of the infraspinatus tendon. The tear measures 9mm longtidinally x 7mm transverly and passes through approximatel 50% of the width of the tendon. the remaining rotator cuff tendons are normal. There is an anterosuperior sublabral foramen, there is no labral tear. There are mild AC joint degenerative changes.There is low grade bursitis. There is no muscle belly wasting. There is a split within the biceps tendon, signal within the biceps tendon is normal in keeping with this being a longstanding finding. Acromion is type II. There is no other abnormality in the ...... and it stops there.
    MRI TWO REGION SPINE
    HISTORY
    C5/6 disc bulge
    TECHNIQUE
    Sagittal T1, T2, axial [email protected] W imaging of the cervical and lumbar spine.
    CERVICAL SPINE
    No loss of vertebral body heights. There is a Schmorl's node present at the C4 vertebral body inferior endplate. Mild disc space narrowing is present at C4/5 and C5/6........artefact mildly degrades from image quality. Cord signal does appear normal. The cord is normal in size. The posterior fossa structures have a normal configuration.
    At C4/5 there is a broadbased disc bulge which results in mild foraminal narrowing. The CSF anterior to the spinal cord is effaced. Cord signal is normal.
    At C5/6 there is a left focal paracentral disc protrusion which effaces the anterior aspect of the spinal cord and displaces it posteriorly. Marginal osteophytes are present at this level. These changes result in moderate left side foraminal stenosis.
    There is a shallow left paracentral / foraminal disc bulge at C6/7 resulting in minor foraminal narowwing and partial effacement at the CSF anterior to the spinal cord.
    LUMBAR SPINE
    Vertebral alignment is satisfactory. No loss of vetebral body heights. Marrow signal is normal. Disc space narrowing and loss of hydration signal is present at L3/4. The spinal cord terminates at the level of the T12/L1 disc. The conus is normal in size and signal.
    There is minor shallow bulging of the disc at L3/4 which only just abuts the thecal sac but does not efface it and there is no compromise of the exiting or descending nerve roots.
    Can you please explain all of this, will I need any operations and how long for recovery.
    I have now been waiting over 6 weeks to see a neurosurgeon, the Orthopedic says I need to see him and my GP is trying to get this done asap.
    I cannot believe all of this came from one fall although an incredibly painful one.
    Please help.
    Thank you.

    Last edited by Mod08; 03-08-2009 at 02:04 PM. Reason: Your post has been moved to the correct board.

     
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    Old 03-08-2009, 05:56 PM   #2
    jennybyc
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    Re: MRI Results-please assist in layman terms

    I'll give it a go since I recognize most of the terminology.

    Wrist:You have a fracture of a wrist bone(there are 7) but it is in the correct place so nothing needs to be done for it. Your carpals(bones of the hand) were obscured. Basically, you cracked the bone but just letting it heal will be fine.

    Shoulder: they found a partial tear of a rotator cuff tendon. there are 4 of them and the one you injured is over your shoulder blade....explains the pain. They don't usually operate on them until they completely tear. Your AC joint where the collar bone and shoulder blade meet, has some arthritis and the huge bursa under it is slightly inflamed. I'll have to check the labrum stuff...not completely sure on that(been years since I took those anatomy courses).Basically, your shoulder has a tear that will probably need some PT to strengthen it and the rest is either normal for age or normal for you(your split tendon you were probably born with).

    Spine:Cervical first. They mention a Schmorl's node and from what I remember, they are common and of little consequence. I have them on almost every vertebra in my back. And the bones themselves are okay. It's the disks. The disks are in between the vertebrae so C4-5 is in between C4 and C5. They saw a narrowing of that space confirming the disk has probabaly ruptured . From a different angle they can see that the disk has a broad rupture. Think of a disk as having a spongy center to cushion the bones and a tough ring around the outside to hold it all in. Sometimes the outer ring breaks and you get a small intense bulge almost like a balloon sticking out. Or the whole thing can get squished down and push out in different directions and seem like a squished donut. That's what you have and it's pushing against the area where your individual nerves exit the vertebra. Between C5 and 6 you have another disk that has ruptured in the balloon type configuration and it's pushing toward the spinal cord but not compressing it. You also have some arthritis that is causing narrowing of the area where your nerves exit from the vertebra. Between C6and 7 you have another squished donut type disk bulge that is causing a small amount of narrowing on the left side again where the nerves exit the bone.

    The good news from all of this....your spinal cord is fine.

    Lumbar spine: bones and alignment look good. Your spinal cord ends at T12-L1...NORMAL(all our spinal cords end here). the disk in between L3 and 4 is dried out.....means it's a good candidate to tear. It appears from a different angle to be bulging outward but it's not touching anything.

    Your doc probably wants a neurosurgeon to evaluate the situation in your neck and the amount of pain/numbness your in. Your spinal cord is okay so that is very good news but you have pressure on the nerves that exit the bones and maybe causing the problem. New research has shown that if you are going to operate to relieve the pressure, it's best to do it within the first year.

    But here's the secret to spine problems. Pain, as bad as it might be, is a sign of a nerve that is damaged and doesn't like it. It is screaming at you. But with physical therapy and medications, they can often get the nerves to quiet down. So pain is good. It's a sign of an alive nerve. Numbness/tingling is a sign of a nerve in distress as is dropping stuff(it's actually called Clumsy Hand Syndrome). That is a nerve that needs to be relieved of the pressure to stop it from dying. Paralysis is the nerve dying or dead(you're not there).

    So I would suspect your doc is going to take a good look at whether or not to relieve the pressure surgically or if it can be done medically.

    I'm so sorry you fell. I hope you get good news but don't freak out. Take it one day at a time and let time and the docs deal with this. You might need surgery at some time and it's not that bad. Spine surgery has come a long way in the past 10 years especially. It's not the horror it used to be.

    gentle hugs..............Jenny

     
    Old 03-08-2009, 11:30 PM   #3
    Calflady
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    Re: MRI Results-please assist in layman terms

    Quote:
    Originally Posted by jennybyc View Post
    I'll give it a go since I recognize most of the terminology.

    Wrist:You have a fracture of a wrist bone(there are 7) but it is in the correct place so nothing needs to be done for it. Your carpals(bones of the hand) were obscured. Basically, you cracked the bone but just letting it heal will be fine.

    Shoulder: they found a partial tear of a rotator cuff tendon. there are 4 of them and the one you injured is over your shoulder blade....explains the pain. They don't usually operate on them until they completely tear. Your AC joint where the collar bone and shoulder blade meet, has some arthritis and the huge bursa under it is slightly inflamed. I'll have to check the labrum stuff...not completely sure on that(been years since I took those anatomy courses).Basically, your shoulder has a tear that will probably need some PT to strengthen it and the rest is either normal for age or normal for you(your split tendon you were probably born with).

    Spine:Cervical first. They mention a Schmorl's node and from what I remember, they are common and of little consequence. I have them on almost every vertebra in my back. And the bones themselves are okay. It's the disks. The disks are in between the vertebrae so C4-5 is in between C4 and C5. They saw a narrowing of that space confirming the disk has probabaly ruptured . From a different angle they can see that the disk has a broad rupture. Think of a disk as having a spongy center to cushion the bones and a tough ring around the outside to hold it all in. Sometimes the outer ring breaks and you get a small intense bulge almost like a balloon sticking out. Or the whole thing can get squished down and push out in different directions and seem like a squished donut. That's what you have and it's pushing against the area where your individual nerves exit the vertebra. Between C5 and 6 you have another disk that has ruptured in the balloon type configuration and it's pushing toward the spinal cord but not compressing it. You also have some arthritis that is causing narrowing of the area where your nerves exit from the vertebra. Between C6and 7 you have another squished donut type disk bulge that is causing a small amount of narrowing on the left side again where the nerves exit the bone.

    The good news from all of this....your spinal cord is fine.

    Lumbar spine: bones and alignment look good. Your spinal cord ends at T12-L1...NORMAL(all our spinal cords end here). the disk in between L3 and 4 is dried out.....means it's a good candidate to tear. It appears from a different angle to be bulging outward but it's not touching anything.

    Your doc probably wants a neurosurgeon to evaluate the situation in your neck and the amount of pain/numbness your in. Your spinal cord is okay so that is very good news but you have pressure on the nerves that exit the bones and maybe causing the problem. New research has shown that if you are going to operate to relieve the pressure, it's best to do it within the first year.

    But here's the secret to spine problems. Pain, as bad as it might be, is a sign of a nerve that is damaged and doesn't like it. It is screaming at you. But with physical therapy and medications, they can often get the nerves to quiet down. So pain is good. It's a sign of an alive nerve. Numbness/tingling is a sign of a nerve in distress as is dropping stuff(it's actually called Clumsy Hand Syndrome). That is a nerve that needs to be relieved of the pressure to stop it from dying. Paralysis is the nerve dying or dead(you're not there).

    So I would suspect your doc is going to take a good look at whether or not to relieve the pressure surgically or if it can be done medically.

    I'm so sorry you fell. I hope you get good news but don't freak out. Take it one day at a time and let time and the docs deal with this. You might need surgery at some time and it's not that bad. Spine surgery has come a long way in the past 10 years especially. It's not the horror it used to be.

    gentle hugs..............Jenny

     
    Old 03-08-2009, 11:33 PM   #4
    Calflady
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    Re: MRI Results-please assist in layman terms

    Dear Jenny,
    Thanks for both the advise and the hugs very much appreciated. I feel a whole lot better than I did before your email. Now understand what's going on.
    I'll update as it goes on, tomorrow fracture clinic again for another x-ray as they couldn't see the scaphoid, geez I hope they don't put it in plaster again. There was a very clear break right through the scaphoid at the fracture clinic but hidden in the MRI.
    Thanks again.
    Your great.

     
    Old 03-09-2009, 09:58 AM   #5
    jennybyc
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    Re: MRI Results-please assist in layman terms

    MRI's are good for soft tissue problems but lousy at finding fractures. Xrays and CT's are better. I fell in last week's snow storm and had to have my neck CT'd just to make sure my pain wasn't a break. MRI is next.

    gentle hugs.............Jenny

     
    Old 03-10-2009, 01:57 AM   #6
    Calflady
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    Re: MRI Results-please assist in layman terms

    Quote:
    Originally Posted by jennybyc View Post
    MRI's are good for soft tissue problems but lousy at finding fractures. Xrays and CT's are better. I fell in last week's snow storm and had to have my neck CT'd just to make sure my pain wasn't a break. MRI is next.

    gentle hugs.............Jenny
    Did I moz you? (Sorry Ozzie slang- means did I give you bad luck). If I did I'm sorry. Hope all goes well with the MRI. What do they think you've done to yourself?
    Snow storm? Where are you, we live in the tropics next to the Great Barrier Reef in Queensland, Australia. We only see that on the T.V.

    Warmesst wishes, Sharyn

     
    Old 03-10-2009, 11:03 AM   #7
    jennybyc
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    Re: MRI Results-please assist in layman terms

    I'm in the northeast US and we are still in "nor'easter" season. We get these storms that roll up the whole US coast and they bring down cold Canadian air and turn from rain to snow and we can get socked. The worst storm ever to hit the northeast was way back in 1888....over 4 feet of snow fell. I've seen up to 3 feet but I hope to never see 4!

    Monday was only a foot and it will melt fast. And no, you didn't moz me. I'm a klutz!

    Jenny

     
    Old 03-10-2009, 10:23 PM   #8
    Calflady
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    Re: MRI Results-please assist in layman terms

    Geez, anything under 27 degrees celcius is freezing to me I'd end up an ice cube. I once met a gorgeous lady in Bali from Alaska who has 24hr darkness for 3 odd months-good grief. Where we are we have 320 days of sunshine a year although we almost lost it the other day with a cyclone which are pretty frequent up here.
    Cheers Klutz!
    Sharyn

     
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