MRI Report Overview
Age: 31, Female. Patient has a history of melanoma, inappropriate sinus tachycardia, depression, and anxiety. Current medications include metoprolol, duloxetine, amlodipine, levothyroxine, vitamin D3, a probiotic, buspirone, and gabapentin. For the past six months, the patient has experienced pain in the upper back and mid-shoulder blade area, which sometimes radiates to the chest. Cardiac conditions have been excluded through echocardiogram, two stress tests, and other laboratory evaluations. Although the physician indicated that the MRI findings do not suggest a spinal origin for these symptoms, the patient noted that the observations regarding the T3-4 vertebrae correspond with their pain—raising questions about the interpretation of the findings. MRI of the cervical and thoracic spine was conducted without the use of contrast. **Clinical Background:** Chronic back pain; suspected cervical radiculopathy. **Comparison:** Previous imaging from February 6, 2025, was reviewed. **Procedure performed:** MRI scans of the cervical spine used sagittal T2, axial T2, sagittal T1, sagittal STIR, and bilateral sagittal oblique T2 sequences. Thoracic spine MRI utilized sagittal T2, axial T2, sagittal T1, axial T1, and sagittal STIR sequences. **Findings from the cervical spine MRI:** - Alignment appears normal. - Both vertebrae and marrow signal are normal. - No abnormalities identified in the cervicomedullary junction and cervical cord; no signs of cord compression, abnormal cord signal, or syrinx. - At C2-3, C3-4, and C4-5 levels, there is no significant narrowing of the central canal or foramina. - At C5-6, disk bulging is present along with mild left uncovertebral spurring, resulting in minor left foraminal narrowing, but the central canal and right neural foramen remain patent. - C6-7 displays minor disc bulging, with no significant stenosis detected in the central canal or foramina. - C7-T1 shows no significant findings regarding canal or foraminal stenosis. - Paraspinal muscles and surrounding soft tissues are normal. **Findings from the thoracic spine MRI:** - Alignment is normal. - Normal vertebrae and marrow signal noted. - The thoracic caudal cord appears normal, showing no signs of compression, abnormal signal, or syrinx. - At the T3-4 level, there is evidence of disc dehydration and reduced disc height, accompanied by diffuse bulging. A central posterior protrusion approaches the anterior margin of the thoracic cord, resulting in mild overall central canal stenosis. - The remaining segments of the central canal remain open. - Neuroforamina are patent throughout. - Paraspinal musculature and paravertebral soft tissues are normal. **Conclusion:** No significant central canal or foraminal stenosis detected in the cervical or thoracic regions of the spine.
Answers (1)
3/19/2025, 4:01:28 PM
OpenHealth AI
The MRI report indicates some findings in your cervical and thoracic spine, particularly at the T3-4 level. While the report shows no significant abnormalities that would commonly explain your symptoms, it's important to understand these results and consider your ongoing pain.
Explanation:
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MRI Findings:
- Cervical Spine: Generally normal with slight disk bulging at C5-6 and C6-7, which does not seem to cause significant issues.
- Thoracic Spine: At the T3-4 level, there is dehydration and reduced height of the disc, along with some bulging that mildly narrows the central canal but does not cause significant stenosis. This could possibly relate to your upper back and shoulder pain.
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Symptoms:
Your pain seems to radiate and has persisted for six months. This can be frustrating, especially with normal cardiac work-ups indicating no heart issues. The discrepancy between your symptoms and MRI findings might lead you to question the interpretation, particularly regarding the T3-4 area.
Next Steps:
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Symptom Management:
- Pain Relief: Continue any currently prescribed medications that assist with pain (like gabapentin) and consider discussing adjustments with your physician if pain is not managed effectively.
- Physical Therapy: Engaging in physical therapy focusing on stretching and strengthening the upper back might help alleviate some discomfort. A physical therapist can provide tailored exercises and modalities aimed at reducing your symptoms.
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Monitoring:
- Keep a pain diary noting when pain occurs, activities that worsen it, and any accompanying symptoms. This can help pinpoint triggers and provide useful information for your healthcare provider.
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Follow-Up Consultations:
- Discuss the MRI findings again with your doctor, emphasizing the correlation between the T3-4 bulging disc and your pain. They might consider additional imaging or referrals to specialists, such as a neurologist or pain management specialist, if symptoms persist.
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Emotional Support:
- Given your history of depression and anxiety, consider reaching out for support or counseling. Chronic pain can affect mental health, and having a support system or therapy can be beneficial.
It’s understandable that having a condition without clear answers can be distressing. Focus on the approaches that will help you manage your daily activities better and bring relief. Tailoring your management plan to your unique symptoms is key. Please keep me posted on how you're feeling, and if there's anything more specific you’d like to know.
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