slboudreauParticipantMay 15, 2018 at 10:21 amPost count: 2
I am a 43 year old female with a 14 year military career from which I received a medical release due to “exercise intolerance” and a variety of other symptoms a will list below. A few weeks ago in the evening my hand felt like it “fell asleep” (wasn’t holding it in an awkward position or leaning on it) and I had extreme difficulty navigating my buttons when trying to get ready for bed. When I woke in the morning and it was the same (pins, needles and very weak). I went to outpatients and they performed an MRI of my brain and cervical spine to rule out stroke or other central nervous system disorders. Because I don’t have a family doctor, the results were being sent to an Internal Medicine specialist. When I phoned the specialist for follow up I was advised by the receptionist that “the doctor would not be calling me unless she sees something major on my MRI”. I still haven’t heard anything back so I requested a copy of my MRI results. Here is what was noted:
Straightening of the cervical spine. Multilevel degenerative disc disease and spondylisis at C4-C5, C5-C6 and C6-C7 with disc space narrowing, endplate bone spurring and degenerative changes of the Luschka joints. No marrow signal abnormalities. Normal position of the cerebellar tonsils.
No abnormality at C2-C3 or C3-C4.
At C4-C5 there is diffuse disc osteophyte complex which is causing flattening of the anterior aspect of the thecal sac and displacing CSF indicative of grade one cervical spinal stenosis. Minimal impingement of anterior cord. Bilateral neural foraminal narrowing, more severe on the right.
At C5-C6 there is diffuse disc osteophyte complex impinging the anterior aspect of the thecal sac and displacing CSF in keeping with grade one cervical spinal stenosis. Mild bilateral neural foraminal narrowing more significant on the right.
At C6-C7 there is just a mild diffuse disc osteophyte complex causing flattening of the anterior aspect of the thecal sac. No significant central canal stenosis. Neural foramina are patent.
No high signal in cervical cord indicate demyelination.
Impression: No evidence of cervical cord demyelination. Multilevel degenerative disc disease and spondylisis at C4-C5, C5-C6 and C6-C7. Grade one cervical canal stenosis at C4-C5 and C5-C6. Bilateral neural foraminal narrowing at C4-C5 and to a lesser extent C5-C6, worse on the right.
History of symptoms prior to my left hand tingling and weakness include neck pain, stiffness and decreased ROM for several years (thought it was normal aging and wear and tear from my military career), random muscle twitches in my leg and arm muscles, twitching of my left thumb and baby finger, arm weakness when performing tasks overhead, leg weakness when climbing stairs and walking long distance,daily headaches, and most recently, pain and and decreased ROM of my right upper arm that was thought to be rotator cuff related for which physio was prescribed with no improvement, and a burning pain in the back right side of my head.
CT of brain was normal other than “A couple of nonspecific high signal intensity foci in subcortical white matter of right frontal love, not likely of any clinical significance.”
My questions are:
Could the MRI results explain my symptoms?
Do I need to seek follow up for my MRI results?
Thank you for your time and consideration.
Donald Corenman, MD, DCModeratorMay 16, 2018 at 7:45 pmPost count: 6403
- This topic was modified 5 months ago by slboudreau.
Paresthesias in the hand can be generated by nerve compression in the arm (see https://neckandback.com/conditions/carpel-tunnel-syndrome/, https://neckandback.com/conditions/cubital-tunnel-syndrome/ and https://neckandback.com/conditions/thoracic-outlet-syndrome/ but this is commonly caused by nerve compression.
The C5 nerve (C4-5 level) is compressed (“Bilateral neural foraminal narrowing, more severe on the right”) but this nerve does not descend into the hand so we can rule that one out.
C5-6 is read as “Mild bilateral neural foraminal narrowing more significant on the right” so if we can trust the accuracy of this reading then we can rule out the C6 nerve (but trusting that report could be a mistake).
C6-7 is also found to be OK (“Neural foramina are patent” meaning there is no compression).
There is no mention of the C7-T1 level (C8 nerve) but this nerve (along with the T1-2 level-again-no mention) also descends into the hand.
A good physical examination will differentiate these conditions and maybe having a spine surgeon do the exam and read these films would be your best bet.
Dr. CorenmanPLEASE 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.If this forum has helped you, please let Dr. Corenman know!slboudreauParticipantMay 16, 2018 at 8:29 pmPost count: 2
Thank you for your reply Dr. Corenman. I will return to outpatients to see if I can get a referral to a spine surgeon. Do you think the MRI results could explain the persistent pain in my right upper arm (constant nagging outer arm pain with sharp pain upon certain movements like reaching back for a seatbelt, throwing or sudden movements like reaching for a falling object)?
SherriDonald Corenman, MD, DCModeratorMay 17, 2018 at 2:40 amPost count: 6403
Pain from arm motion can be generated by the shoulder too (see https://neckandback.com/conditions/rotator-cuff-syndrome-shoulder-impingement-syndrome/). Right upper arm pain can originate from the C5 nerve which is compressed as noted by your MRI. See https://neckandback.com/conditions/symptoms-of-cervical-nerve-injuries/
Dr. CorenmanPLEASE 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.If this forum has helped you, please let Dr. Corenman know!
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