[nibbler72]

#7834

HI

Just after your opinion as to whether this MRI image possibly shows Spondylolisthesis L5/s1. When i had the scan done about 1 year ago the radiologist said everything looked ok however since then my leg/buttock pain has got steadily worse, with pain radiating to the calf, especially when walking. I recently saw a Osteopath who reviewed the MRI and said it showed Spondylolisthesis and i have started on some core muscle strenghting work to try and rectify this. Early days yet.

s1275.beta.photobucket.com/user/nibbler72/media/003B3958_zpsab033ea6.jpg.html?#/user/nibbler72/media/003B3958_zpsab033ea6.jpg.html

Any thoughts much appreciated

thks
Nick

[Donald Corenman, MD, DC]

#7836

In order to diagnose an isthmic spondylolisthesis in the lumbar spine, multiple views are required. These include sagittal T2, STIR and axial views (T2 typically). The problem with using an MRI to diagnose this condition is that the defects are subtle and many times, the technician that performs the actual scan might miss the “cut” through the defect.

There are also radiologists who are not musculoskeletal fellowship trained and might not be aware of the subtle signs of this defect. This condition is the most commonly missed diagnosis (along with a far lateral disc herniation) on an MRI.

I cannot open your images.

Dr. Corenman

[nibbler72]

#7837

Hi
Thanks for the response,. Would you say that x-ray is a better method to diagnose this rather than MRI then?

Strange you can’t open the image, should just be a case of copying that link into the browser

Rgds
Nick

[Donald Corenman, MD, DC]

#7842

The gold standard to diagnose an isthmic spondylolisthesis is a CT scan. X-rays can be very helpful and performed correctly, an MRI is very good.

Dr. Corenman

[Author]

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