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  • Avatarniki
    Participant
    Post count: 10

    Thank you Doc for your efforts in demystifying MRIs for the betterment of us confused and pained people of the internet. It really means a lot.

    Symptoms: That being said, I’ve had chronic, all over pain for 16 years. 8 years ago, random pain in my right hip put me in a wheelchair for 1 year, then magically resolved. I’m 33 now, and for the last 3 years I have had back spasms 3 times monthly that I attempt to manage with medications, rest but was otherwise stumped. My left arm has been numb permanently and lost motor skills that seems to have a transient severity. I always have pins and needles in my hands and feet, and my muscles tire easily.

    I have a positive HLA-B27 gene, but we’ve ruled out a lot of rhuemtological, neurological symptoms.

    —- Here are my MRI results from Stanford Imaging, I’m happy to report my Thoracic and Lumbar Spine are completely “Normal” — Now it’s time for my pain in the neck!

    1. Mild multilevel degenerative changes of the cervical spine as described above. Minimally increased prominence of the small posterior central disc protrusion at C5-C6, possibly related to differences in scan technique, otherwise cervical spine is stable from 4/17/2018 MRI. No significant neural foraminal or spinal canal stenosis.

    2. Normal MRI of the thoracic spine.

    CLINICAL HISTORY: 33 years of age, Female, cervical radiculopathy.

    COMPARISON: MRI 4/17/2018.

    PROCEDURE COMMENTS: MRI of the cervical and thoracic spine was performed without IV contrast at 3 Tesla. The following MR sequences were obtained: 3 plane localizer SSFSE, sagittal T2, sagittal T1, sagittal STIR, axial T2, and axial MERGE.

    FINDINGS:

    Localizer image: No visible abnormality.

    Alignment: Straightening of the normal cervical lordosis.

    Bone marrow: Normal for age. Vertebral body heights are preserved.

    Discs: Disc desiccation and mild disc height loss from C4-C7. Thoracic disc heights are preserved.

    Vertebrae: Multi-level degenerative changes as follows:

    Cervical spine:

    C2-C3: Mild facet hypertrophy. No significant neural foraminal or spinal canal stenosis.

    C3-C4: Left asymmetric mild uncovertebral and facet hypertrophy which result in mild left neural foraminal stenosis. No significant spinal canal stenosis.

    C4-C5: Broad-based posterior disc osteophyte complex, left asymmetric mild uncovertebral and facet hypertrophy which result in partial effacement of the ventral thecal space without significant spinal canal stenosis. No significant neural foraminal stenosis.

    C5-C6: Small posterior central disc protrusion, mild uncovertebral and facet hypertrophy which result in near-complete effacement of the ventral thecal space with mild indentation of the ventral spinal cord and mild spinal canal stenosis. No significant neural foraminal stenosis.

    C6-C7: Broad-based posterior disc osteophyte complex, mild uncovertebral and facet hypertrophy which result in partial effacement of the thecal space without significant spinal canal stenosis. No significant neural foraminal stenosis.

    C7-T1: Mild facet hypertrophy. No significant neural foraminal or spinal canal stenosis.

    Thoracic spine: No significant degenerative changes, neural foraminal or spinal canal stenosis.

    Cord: Normal.

    Extra-vertebral soft tissues: Normal.

    Visualized brain: Normal.

    Visualized chest: Normal.

    Additional comment: None.

    There is no component information for this result.
    —–

    Thanks so much again for all your help to us!

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7525

    You note “I’ve had chronic, all over pain for 16 years. 8 years ago, random pain in my right hip put me in a wheelchair for 1 year, then magically resolved”.

    You also note “My left arm has been numb permanently and lost motor skills that seems to have a transient severity. I always have pins and needles in my hands and feet, and my muscles tire easily”

    This sounds somewhat like an inflammatory disorder like MS or polymyalgia rheumatica but your tests are normal (I assume labs are normal too). Your neurological symptoms “pins and needles in my hands and feet, and my muscles tire easily” need to be looked into as they cannot be generated by your spine based upon your report. Have you had a neurological consultation and EMG/NCV test?

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Avatarniki
    Participant
    Post count: 10

    Hi Doc! My apologies, I didn’t expect for you to write back so quickly.

    That’s a great question. I’ve seen a Mayo clinic nuerologist and they don’t believe it’s Ms. I’ve had multiple brain MRIs as well as 2 EMGs. (those are not fun, by the way!)

    That’s good to hear about my spine, thanks! So is it rather normal for a 33 year old woman to have those results with all those osteophytes? I have a positive HLA-B27 for aclondysis spondylitis but not sure where to go or look for there since it’s just a marker.

    My symptoms are the worst and have really affected my quality of life, sadly.

    I know I said this last time, but truly.. Thank you for your help.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7525

    You need the best, most experienced neurologist you can find. The Mayo is a good clinic but most individuals see “lower-rung” department members who don’t have the experience you need. Research the names on PubMed papers that have written about your condition and then pick the most-senior author as the one you should see.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Avatarniki
    Participant
    Post count: 10

    Thanks Doc, so I’ve reached out to additional nuero but it does seem hard for me to be heard. I also wanted to ask if you had experience with ankylosing spondylitis?

    I didn’t mention I my positive gene marker for AS and mild degenerative changes along my labrum of my hip and “increased signal along sciatic nerve”

    Is it possible that the MRI issues with my neck could cause all over pain and hand tingling? is there any osteo type imaging that could rule out AS?

    When I went down this path they suggested Humira out steroids as a trial and I just really wanted to make sure our diagnosis was right with images needed.

    Best,

    Niki

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7525

    Ankylosing Spondylitis can cause migrating pains but generally announces itself with spinal ligament ossification and sacroiliac involvement. Did you have an MRI of the SI joints?

    They probably do not have a diagnosis currently and may be advocating for Humira as a trial. Have you seen a rheumatologist?

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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