I am relatively new to this site so apologise if I am posting in the wrong place.
I have had an MRI on my back and would appreciate if someone could help me understand the findings as my doctor has said all is ok.
Findings:
The conus lies at T12-L1
At L3-L4 level: There is minimal posterior disc bulge with mild degenerative change of the facet joints but no evidence of nerve root or cauda equina compression. The disc height and hydration are preserved.
At L4-L5 level: There is moderate posterior broad-based disc bulge as well as degenerative change and hypertrophy of the facet joints and ligamentum flavum. There is subsequent narrowing of the lateral recesses and likely impingement on the traversing L5 nerve roots particularly on the right. The disc and hydration are preserved.
At L5-S1 level: There is disc dehydration, mild broad-based posterior disc bulge as well as mild degenerative change of facet joints but no evidence of neurological compromise.
Conclusion: Mild multilevel degenerative change as described above but possible impingement on the traversing L5 nerve root at the L4-L5 level.
This scan was taken last September and since then my pain has gotten much worse. I can barely move as my right knee has decided to stop bending correctly or allowing me to put weight on it. This happen in December when I fell and landed on my back, one of four falls since.
I am not sure if this is relevant but I am deficient in VitD at 11 nmol, B12 is low at 243 ng/l and deficient in folate at 2.5 ug/l.
All help understanding these findings would be greatly appreciated. I apologise if I have posted in the wrong place.
Thank you for taking up time to read my post.
Written by
Bellao01
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As far as I can tell, there is no mention of osteoporosis or osteopenia in this MRI report but people usually have BDM assessments for that from DXA scanning.
I don't know if anyone would be able to provide the sort of interpretation that you would like but there is information about degenerative discs, facet joints etc. on other forums on HU such as Pain Concern: healthunlocked.com/search/d...
You will also see quite a few posts there about particular vertebrae junctions and pairs such as those that you list: e.g., L4 L5, L5 S1 etc. You can read about people's symptoms that are associated with this (e.g., sciatica or leg pain is not unusual with some L5-S1 issues).
The report mentions "likely impingement on the traversing L5 nerve roots particularly on the right" and that's sometimes associated with leg pain or sciatica. NHS Choices has some useful general information: nhs.uk/conditions/Slipped-d...
I've no idea if any vertebra root impingements distinctively associated with knee pain but it seems as if that may be associated with the aftermath of your December fall and therefore not something that was necessarily present in the scan?
Thank you for your reply and links provided, it is very much appreciated.
I thought this may be the wrong site to post so thank you for pointing me in the right direction. I will check out the details you have given me and repost in the pain concern.
disclaimer.......I am no expert, but from my experience in interpreting MRI results (I am an NHS professional) ........in my opinion.....
jumping to the conclusion - as the rest is just leading to that.... degenerative change means problems have occurred over time, this can happen for many reasons including age, medication, medical conditions, basically - wear and tear!
Impingement on nerve roots sort of means that nerves are getting trapped. as its your lower spine (L4-L5) this would probably show up as symptoms in the legs.... weakness, tingling, pain, numbness etc.
According to NICE (who are the organisation that specify health guidelines (allowed drugs/recommended treatments/blood results etc) that NHS doctors/health professionals adhere to when treating patients) you do have a vitamin D deficiency - Nice say less than 25nmol is deficient. (nice.org.uk/guidance/ph32/d....
I hope this helps - don't take my word for all this though - I suggest you visit your GP to discuss your results.
I have been taking VitD over the counter tablets so hopefully my levels will rise over time.
You are correct about the changes over time, it turns out my back had problems since 2006 and despite my gp's requesting 3 times, I never got the physio I needed. As I was told my scans were perfectly fine I was unaware I needed to treatment.
In regards to my knee, I ended up at hospital yesterday. The scan I had in February stated I had moderate joint effusion, thinning of the patellor and a popiliteal cyst, once again I was told my scan was normal so have just put up with the pain as I thought I was imagining it.
The hospital felt and looked at the area of calf and distorted knee and think the cyst has now ruptured and the doctor wants me referred to orthopaedics. He called it a Bakers Cyst and gave me diclofenic cream as I can not take orally due to stomach issues.
I can not help but wonder, if I had been told about my results at any point and treated, would I be bedbound now as I can not put any weight on my knee and the pain is so debilitating. Ouch is all I can say.
my husband had a bakers cyst a few years ago, very painful, didn't get treated though watched. That knee is now fine so do feel reassured that the discomfort can go. If you can't manage painkillers I do recommend the actipatch, which provides pain releif and help with inflammation, and can be worn 24hrs a day. I use them a lot as developed peptic ulcers from medication last year.
Thank you LoisParker. Happy to know this could eventually go and that is reassuring. Hope your hubby is find now.
I am already on a Butrans patch @ 20mg per hour that last for 7 days, Co-codomol, gabapentin and tramadol as pain relief for my whole gut dysmotility. With all that medication, feeling the pain I have been experiencing just did not feel right. I think the referral is more for the fluid to be removed so that it can release the pressure?
The knee pain is bad but the leg from calf down is numb and cold, it's driving me nuts!
Did they find a cause for your husband?
He had the giant calf and horrible discomfort. I had to drive him to work for quite a while. I don't think they tried to find a cause, and they didn't remove the fluid...don't know why, but all surgery has risks so maybe between them they decide to let it do its own recovery. I thought the calf pain happened when they burst and the fluid drains into the calf tissue, and so you just have to cope while the fluid is reabsorbed.
This is over a decade ago and things might have changed.
It makes sense to leave it. I think the cream and suppository helped as I can move around more now without that horrendous pain. My calf feels tense but luckily the size has not changed. The numbness seems to be easing so I am happy to take that.
To be honest, I don't want any medical procedures as everything I have had done goes wrong and leaves me worse than I started.
I will continue with the cream and hopefully it will continue to improve.
I assume then that your husband has not had any further issues with the cyst or his knee? Hoping he is well now and wishing you well to, thank you for your replies.
I have recently started doing popliteal stretching exercises (after I found a very effective popliteal release exercise which resolved a problem I had for years with a wierd sick pain behind my knee). Adding careful knee rehabilitation exercises into your programme as the pain reduces would be sensible- its such a complicated joint and probably best not fiddled with if possible. I had an ACL reconstruction years ago on my other knee which was effective, but only after a lot of thought.
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