I wanted to get your opinion. I have severe sacrum pain and can no longer sit for any period of time. I recently had an MRI which showed multiple lesions suspected to be Tarlov Cysts at S2 and S3, it also showed multiple hemangiomas at S1 and S2.
I have found in my research that doctors mistakenly think that Tarlov Cysts do not cause pain. In my case, they do. My question is: what is the next best test to do a differential diagnosis to show CFS flow/communication and to confirm the Tarlov Cysts? Would this be a CT? Epidurals and other punctures are contraindicated.
Tarlov cysts are not uncommon in the sacrum. Yes, they can cause pain but that is the exception and not the rule. Even some of these cysts that erode the sacral bone can be painless. Before you condemn these cysts as the cause of your pain, you need to have a complete workup for pain generation.
I will assure you that if these are true Tarlov cysts, they contain CSF and communicate with the dural sac. If for some reason you need to prove that, you can have a myelogram performed and a post-myelogram CT scan. You will see that these cysts contain myelographic dye which will confirm that they communicate with the main dural sac.
If you find they do not communicate with the CSF, these could be arachnoid cysts.