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  • Mnkys123
    Participant
    Post count: 2

    Hello-

    Im a 38 year old female experiencing an odd pain in my chest/clavicle area. It started about a year ago and has progressed greatly in the past 6 months.

    I went to my PCP who ordered a MRI of my neck. The weird part of the pain for me is that I have a thobbing pain in my clavicle area near where my sternum and clavicle meet. I was hoping that area woulf be examined during the mri but per the notes it does not seem like it was

    Would you suggest I follow up with a specialist? I have tried PT and I am still in a good amount of pain every day. Here are my results:
    Impression
    Normal cervical cord. No spinal canal stenosis

    Spondylosis greatest at C5-6 left.
    Severe disc degeneration with bridging osteophyte complex and degenerative endplate and vertebral body edema on the left.
    Moderate left foraminal narrowing by osteophyte complex partially impinging the exiting left C6 nerve.

    Arthropathy of the left sternal clavicular joint. However the clavicle is not optimally or routinely imaged or evaluated on cervical spine MRI.

    Narrative
    MRI CERVICAL SPINE WITHOUT CONTRAST

    ** HISTORY **:
    38 year old woman, left-sided arm numbness and weakness. Clinical pain. Rule out clavicle pathology as well as cervical radiculopathy

    ** TECHNIQUE **:

    MR images of the cervical spine were acquired without contrast.

    COMPARISON: None available

    ** FINDINGS **:
    SPINAL CORD: Normal.

    DISCS: Multilevel disc desiccation.

    BONES: Lordotic straightening. Normal vertebral body height. Degenerative endplate and vertebral body edema greatest at C5-6 left. No worrisome marrow replacing process. Mild right C2-3 facet arthropathy.

    Severe C5-6 disc degeneration with bridging osteophyte complex. Trace C5 over C6 retrolisthesis. Normal AP alignment of the remaining cervical spine.

    SOFT TISSUES: Normal.

    C2-C3: No canal or foraminal stenosis.

    C3-C4: No canal or foraminal stenosis.

    C4-C5: No canal or foraminal stenosis.

    C5-C6: Severe disc degeneration with retrolisthesis. Bridging osteophyte complex. Moderate foraminal narrowing with partial impingement of exiting C6 nerve by endplate osteophyte complex. Right foramen is patent.

    C6-C7: No canal or foraminal stenosis.

    C7-T1: No canal or foraminal stenosis.

    OTHER: Visualized posterior fossa is normal.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    You have pain in your sterno-clavicular joint that can on occasion refer from the C6 nerve root (“Moderate left foraminal narrowing by osteophyte complex partially impinging the exiting left C6 nerve”).

    The radiologist also adroitly noted “Arthropathy of the left sterno-clavicular (SC) joint. However the clavicle is not optimally or routinely imaged”.

    Pain can emanate from the SC joint also. The way to determine if the C6 root is causing the pain vs. the SC joint is with diagnostic blocks. First, have a pain specialist inject the SC joint. If you pain is relieved, you now have the diagnosis. If pain is only minimally relieved, then have a selective nerve root block of the left C6 root. If that relieves your pain, then you have a C6 radiculopathy and probably need an ACDF.

    See
    https://neckandback.com/treatments/diagnostic-therapeutic-neck/
    https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic-neck/ and
    https://neckandback.com/treatments/anterior-cervical-decompression-and-fusion-acdf/

    Dr. Corenman

    Mnkys123
    Participant
    Post count: 2

    Thank you!

    Wearing a posture correcting brace has helped a bit.

    What exactly does “Degenerative endplate and vertebral body edema greatest at C5-6 left“ interpret as?! What is body edema? I researched it and it said swelling or a bone lesion. That doesn’t sound good.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    “Degenerative endplate and vertebral body edema greatest at C5-6 left“ is related to significant degenerative disc disease at that level. There is no disc left and you are essentially bone-on-bone. Any impact will overload the endplates and you will then develop micro-fractures. The result of bone fractures is bony edema. See https://neckandback.com/conditions/isolated-disc-resorption-cervical-spine-idr/

    Dr. Corenman

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