Not sure if what I am experiencing can be linked to PCa. What started out as leg cramps evolved into excruciating nerve pain similar to Sciatica but emanating from L5. I had such pain that I was awake all night for 3 nights in a row. I was unable to find any comfortable position Found relief in a Canabis product only made and sold in California, THC 100 Releaf capsules. They shut down the pain completely however All I want to do is sleep.
Any thoughts on the connection?
From todays MRI
CONCLUSION:
1. There is evidence of bilateral sacral alar fractures, which appear new relative to prior imaging. Patient does have a history of osteopenia diagnosed via DEXA scan on 10/28/2021. The possibility of the development of osteoporosis with insufficiency
fractures of the sacrum should be considered.
2. Multilevel disc disease and facet arthropathy throughout the lumbar spine, most pronounced at L4-5 where there is moderate central canal stenosis, severe bilateral subarticular stenosis and mild to moderate bilateral neural foraminal stenosis. Please
see the body of the report above for further specific details regarding degrees of stenoses at each individual lumbar level.
Dictated by (CST): Malik, Amaar, DO on 1/03/2023 at 1:51 PM
Finalized by (CST): Malik, Amaar, DO on 1/03/2023 at 2:05 PM
Narrative
PROCEDURE: MRI SPINE LUMBAR (W+WO) (CPT=72158)
LOCATION: Edward
COMPARISON: EDWARD , MR, MRI PROSTATE (W+WO)(CPT=72197), 4/20/2022, 12:23 PM. North Naperville, XR, XR HIP W OR WO PELVIS 2 OR 3 VIEWS, RIGHT (CPT=73502), 12/15/2022, 5:04 PM.
INDICATIONS: Low back pain radiating to right lower extremity with weakness.
TECHNIQUE: Multiplanar T1 and T2 weighted images including fat suppression sequences. Images acquired in sagittal and axial planes. Intravenous gadolinium was administered followed by multiplanar post-infusion T1 weighted sequences.
PATIENT STATED HISTORY:(As transcribed by Technologist) Patient complains of lower back pain and right lower extremity weakness.
CONTRAST USED: 17 mL of Dotarem
FINDINGS:
LUMBAR DISC LEVELS
L1-L2: No significant disc disease noted. Mild bilateral facet arthropathy and ligamentum flavum thickening. No evidence of stenosis.
L2-L3: Mild disc desiccation and bilateral facet arthropathy. There is a small right posterolateral disc protrusion into the right subarticular zone measuring 6 mm in the AP dimension, best seen on sagittal T2 image 14 of series 5. There is secondary
mild to moderate right subarticular stenosis. No central canal or neural foraminal stenosis.
L3-L4: Mild disc desiccation with mild disc height loss and mild broad-based disc bulge. Mild to moderate bilateral facet arthropathy and ligamentum flavum thickening. There is mild central canal stenosis, moderate to severe bilateral subarticular
stenosis and mild to moderate bilateral neural foraminal stenosis.
L4-L5: There is mild to moderate disc desiccation with disc height loss and broad-based disc bulge. Moderate bilateral facet arthropathy with hypertrophy and ligamentum flavum thickening. There is moderate central canal stenosis, severe bilateral
subarticular stenosis and mild to moderate bilateral neural foraminal stenosis.
L5-S1: Moderate disc desiccation with disc height loss and broad-based disc bulge. Moderate bilateral facet arthropathy with ligamentum flavum thickening. No significant central canal stenosis. There is moderate bilateral subarticular neural
foraminal stenosis.
PARASPINAL AREA: Normal with no visible mass.
BONES: There are bilateral sacral alar fractures with surrounding bone marrow edema and surrounding enhancement. Mild to moderate multilevel facet arthropathy throughout the lumbar spine. No lytic, blastic or destructive osseous changes are noted. No
evidence of lumbar spondylolysis.
Pain Dr. who ordered MRI is going to inject Cortisone to releave pain. Any thoughts?
Prostate cancer and pain
Pain Cancer related or not?
5 months on from initial diagnosis
5 years today from dx
Prednisone from 10mg to 5 with Zytiga?
Could you do the nuclear medicine bone scan to see if you have any bone fractures?
I hate such a detailed reports and you and up with cortisol despite a possibility of having bone fractures?
I am not a doctor but I would go mad with such a report.
That is good that you did the MRI first to see are your nerves and spine compressed or not.
I believe you need a nuclear medicine bone scan and the CT scan to see better your bones, fractures etc.
How your PSA is doing? What is it? Is it going up?
The PSMA PET CT would show if it is a cancer doing a job?
Therefore MRI, then bone scan and possibly PSMA PET CT scan if you believe that the pain is cancer related. You may be able to SBRT the cancer if it is a cancer growing. If the pain is related to fractures than maybe you should be careful to use cortisol injections.
Are you on bone strengthening medication?
I hope that you have good doctors?