LovelifeMemberFebruary 24, 2012 at 8:05 amPost count: 16
Healthy, active female.
Began experiencing mild burning in mid / upper thoracic spine about 10 months ago. Has progressively gotten worse and is worse at night. Area of t5 cannot be palpated/pushed upon, very painful. Radiates at time down spinal column and has into chest as well. Been to therapy, on Meds, etc. And no relief. Burning sensation without touching, and when lying down sometimes feels as if something is pulling or pushing on spine.
Contrast MRI reading is fairly insignificant. Healed compression fractures at t7/8, small hemingioma at t11, some end plate issues at that level from small schmorls nodes. My spine does not hurt here.
My question is concerning the MRI. A few of the images both contrast and pre contrast (t2 fsfe saggital, water:t1 saggital ideal, post contrast t1) show a bright enhancement of the entire vessel length through the vertebral body at t5. I believe they might be the Paravertebral vessels. The enhancement seems very bright and homogenous with contrast. Seems to also show on nerve roots. Is this just a weird imaging issue, a flow artifact or could it mean something? The radiologist did not mention them and my ortho surgeon was rushed and didn’t look. I understand it’s hard to say without viewing the images but I know my spine is very painful and would like some kind of direction on what it could be and what to do.
Has anyone seen this before? I’ve looked and see nothing like it out there on the web.
I do have a hx of atypical meningioma but in the lumbar spine. No recurrence so far and nothing in t-spine
I am more than willing to pay to have someone who’s and expert take another look at my images if deemed necessary.
Thank you for any thoughts.Donald Corenman, MD, DCModeratorFebruary 24, 2012 at 11:24 pmPost count: 8436
My first question would be in regards to the compression fracture of T5. How did it happen and what is the angle of kyphosis (the angular deformity from normal)? A bright signal at T5 could be from the bony injury from the fracture (T2 signal intensity takes 6-12 months to lose brightness from a fracture) or could be from a hemangioma of the vertebra body.
If you had no trauma and the vertebra fractured without force, this could be a pathological fracture (a fracture through abnormally weak bone) from the hemangioma or some other source of bone weakness.
I would contact Dr. Jay Kaiser at Marin Magnetic Imaging in Marin, California for an over-read of your MRI if you have concerns.
Dr. CorenmanLovelifeMemberFebruary 25, 2012 at 12:17 amPost count: 16
Thank you Dr. Corenman. I appreciate your response and this website greatly.
The pain is primarily at T5 and this is where the the vessels seem to light up through/on top of the vertebrae on sagittal view. Not sure if it means anything or if this is normal. It’s the only level I see this at, and I’m not a radiologist so because they don’t mention I’m inclined to think it’s normal but want to make sure. I do not generally have back pain problems unless there is an explanation.
The compression fractures are old and were at T7/T8. One radiologist said compression fractures, another said developmental abnormality (had two MRI’s, as the 1st was non-contrast). They look like wedges, with both superior and inferior end plate deformities. No history of trauma. My blood work was all normal. A small hemangioma was only found at T11.
I will look at contacting Dr. Kaiser as you suggest since I trust your judgment.
Thank you very much for your answer.Donald Corenman, MD, DCModeratorFebruary 25, 2012 at 4:44 amPost count: 8436
It is starting to sound like you have Scheuermann’s disorder (see website). This would account for the appearance of wedged vertebra and endplate irregularity. This can cause local back pain that increases with load.
Dr. CorenmanLovelifeMemberFebruary 25, 2012 at 9:55 amPost count: 16
Thank you so much for your thoughts Dr. Corenman.
My spinal curvature is pretty much normal, so I am lucky for that. Hard to know w/o seeing the images so I understand.
It’s difficult to say what, if anything is wrong to be causing the pain. Maybe I am just one of those cases where nothing explains it. Maybe it’ll go away on its own.
Could be ligament strain since pushing down on the spinous process is very painful. I would suspect that would show in the MRI though.
I will keep trying to feel better and hope to find something that works.
If it continues or worsens I will get another read on the MRI.
Thanks again, you provide a very valuable and appreciated service.Donald Corenman, MD, DCModeratorFebruary 25, 2012 at 11:20 pmPost count: 8436
99% of the time, a diagnosis can be made. Thoracic spine pain can originate from the disc, facets or nerves as well as rarely from surrounding structures. A good work-up should be able to tell what the source of pain is.
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