Understanding My Elbow MRI Results: Should I Be Concerned?
For the past six months, I have been experiencing discomfort in my elbow. After assessing my condition, my orthopedic specialist suspected I might have tennis elbow and suggested that I undergo an MRI. I received the MRI results with contrast, but my doctor is completely booked and I won’t have a follow-up appointment for another three weeks. While I assume he would reach out if any serious issues arose, I can’t shake off my worries, particularly due to the T2 hyperintensity noted in the report and the reference to a possible tumor. Is there anyone who could help clarify these results for me? ***Muscle Findings:*** *In the more superficial section of the brachialis muscle near the elbow joint, a lesion measuring 4.2 x 1.8 x 1 cm has been identified. It demonstrates heterogeneous T2 hyperintensity and subtle T1 hyperintensity, showing slight lobulation. Adjacent fat signal is visible in sagittal series image 14.* ***Nerve Assessment:*** *The ulnar nerve appears normal in its alignment, shape, and signal intensity.* ***Additional Observations:*** *The subcutaneous tissues show no significant abnormalities.* ***SUMMARY OF FINDINGS:*** 1. *An elongated lesion sized 4.2 x 1.8 x 1 cm was found in the superficial section of the distal brachialis muscle. This could indicate a peripheral nerve sheath tumor, a vascular lesion such as a hemangioma, or less likely a myxoma. However, this diagnosis is not fully determined, and further assessment with a contrast-enhanced MRI is recommended.* 2. *No other abnormalities were detected in the left elbow.*
Answers (1)
3/20/2025, 3:20:40 PM
OpenHealth AI
It's understandable to feel anxious after receiving MRI results that mention a possible tumor, especially when you're already dealing with discomfort in your elbow. Let's break down your MRI findings to help clarify things.
Key Points:
- An elongated lesion was found in your brachialis muscle, which could be benign in nature.
- The MRI highlights potential possibilities, but no definitive diagnosis has been made yet.
- Your ulnar nerve appears normal, which is reassuring.
Explanation:
The MRI report describes a lesion measuring 4.2 x 1.8 cm in your brachialis muscle. The terms "T2 hyperintensity" and "T1 hyperintensity" refer to how the tissue appears on the MRI scans – indicating there may be some abnormality in that area. The report suggests that this lesion could be various types of growths, some benign, such as a hemangioma (a blood vessel tumor), while others could be more concerning. It is important to note that just because something is labeled as a "possible tumor," it does not necessarily mean it's cancerous; many tumors are benign.
Next Steps:
- Self-Care and Monitoring: While waiting for your follow-up appointment, continue monitoring your symptoms. Take note of any changes in discomfort, mobility, or any new symptoms (like swelling or changes in the skin over your elbow).
- Activity Modification: Avoid activities that strain your elbow and implement gentle stretching exercises if comfortable. Ice the area to reduce any potential inflammation.
- Stay Informed: Prepare for your upcoming appointment by writing down any questions or concerns you have. Consider asking about the nature of the lesion, what follow-up tests may be needed, and potential treatment options.
- Limit Worry: While it’s natural to feel anxious, try to focus on what you can control. Reassurance from your doctor will be important, and they will evaluate the situation thoroughly when they review your case.
If at any point you experience increased pain, significant swelling, or any symptoms that feel alarming, it may be worth considering seeking urgent care before your scheduled appointment. Remember, many muscle lesions are not serious, and your doctor will provide you with the best guidance once you can discuss the findings in detail.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - **Portocaval shunt size: 9.9 mm** (blood bypassing the liver into the inferior vena cava) - **Arteriovenous shunt size: 4.4 mm** - **Portal vein size: 6.1 mm** (patent) - **Three nodular cystic lesions** located in the perivascular area, with largest measuring 11.6×20.7 mm, enhancing during the venous phase - Liver features a heterogeneous architecture, exhibiting irregular enhancement - Gallbladder appears elongated and slightly enlarged - Other abdominal organs exhibit normal findings **RADIOLOGIST’S ASSESSMENT:** "Congenital portosystemic shunt indicative of Abernethy malformation; less likely arteriovenous malformation (AVM); cannot dismiss the possibility of localized liver lesions." **ADVICE:** Seek consultations with an abdominal and vascular surgeon. ### Blood Tests (August 1, 2025): **Complete Blood Count:** - WBC: 10.44 × 10⁹/L (normal range) - **RBC: 2.1 × 10¹²/L** (LOW - indicating severe anemia) - **Hemoglobin: 69 g/L** (CRITICALLY LOW; normal is 117-166) - Platelets: 403 × 10⁹/L (elevated) **Biochemistry Analysis:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.