OpenHealth Q&A

Seeking Clarity on MRI Findings Amid Ongoing Pain

At 43, I've been grappling with severe pain for the last five months. My neck is extremely stiff, making it challenging to perform everyday activities. Breathing deeply causes chest pain, and I struggle to lift my arms or even stand up from a seated position without discomfort. The stiffness in my legs prevents me from walking or straightening up quickly. Despite undergoing extensive blood tests, most results are negative. However, my CRP and ESR values have remained elevated for five months, and I tested positive for lupus anticoagulant and DVVT. A CAT scan also revealed enlarged lymph nodes that were considered non-pathological. I've attached my MRI findings here in hopes of gaining insight, as I've received little guidance from the physician's assistant I visited. She hasn’t connected the dots and dismissed the results as nonspecific. Any insights would be immensely appreciated. **Cervical Spine** - **Alignment and Vertebrae:** Notable 1 to 2 mm anterolisthesis at C4-C5 with no signs of a compression fracture. - **Marrow:** No lesions found that replace bone marrow; C5 appears to have an atypical hemangioma. - **Discs and Endplates:** Mild disc height reduction noted at C4-C5. - **Spinal Cord:** No indication of compression or signal abnormalities present. - **Soft Tissue:** Normal appearance; no signs of prevertebral edema. - **Findings by Level:** - **C2-C3:** No stenosis in spinal or foraminal regions. - **C3-C4:** Exhibits mild disc bulging; left facet hypertrophy observed with mild left foraminal stenosis, though spinal stenosis is not evident. - **C4-C5:** Similar to the previous level with mild disc bulge and left facet hypertrophy leading to mild left foraminal stenosis, no spinal stenosis present. - **C5-C6:** Mild disc bulge, no stenosis observed. - **C6-C7:** Central and left paracentral disc protrusion with mild left foraminal stenosis, intact spinal pathway. - **C7-T1:** No stenosis found. - **Impression:** Mild degenerative changes in the cervical spine resulting in mild neural foraminal stenosis on the left side across multiple levels. **Left and Right Femur** - **Bone:** No evidence of edema, fractures, osteonecrosis, or specific lesions. Bilateral femurs display scattered symmetric areas indicative of hematopoietic marrow. - **Soft Tissues:** There is slight hyperintensity at the myotendinous junctions of the right gluteus medius and minimus extending to their insertion on the greater trochanter. No muscular edema or atrophy found. Presence of small interstitial tears in the conjoined hamstring tendons, but otherwise, the tendons remain intact with no masses or fluid accumulation. - **Impression:** Mild hyperintensity identified at the myotendinous junctions of the right gluteus medius and minimus; this finding is nonspecific and may suggest myositis.

Answers (1)

7/7/2025, 11:50:48 PM

OpenHealth AI

I'm sorry to hear about the significant pain and challenges you're facing. It sounds frustrating to have ongoing symptoms without clear guidance. The findings from your MRI suggest that there are some mild degenerative changes in your cervical spine and a few other findings in your femurs and tendons. Here's a breakdown of the key points regarding your MRI results:

Main Points

1. Cervical Spine Findings: Mild degenerative changes leading to mild foraminal stenosis at several levels. This could contribute to nerve impingement and may explain some discomfort.
2. Femur Findings: Some nonspecific changes indicating possible myositis (inflammation of muscle tissue) at certain tendon junctions, but no critical damage like fractures or significant tears.
3. Ongoing Symptoms: Your elevated CRP and ESR levels suggest there's some inflammation in your body, consistent with conditions like lupus or other inflammatory disorders.

Explanation

• Cervical Spine Issues: Mild disc bulging and foraminal stenosis can compress nerves, potentially causing pain, stiffness, and weakness that you've described. When the nerves that run from the spine down to the arms and legs are affected, it can make movements painful or difficult.
• Muscle and Tendon Involvement: The hyperintensity at the myotendinous junctions and mild tears in the hamstring tendons may also contribute to your symptoms, as muscles and their connection to bones can affect mobility and strength.

Next Steps

1. Monitor Symptoms: Keep track of your symptoms, including pain levels and any changes in mobility. Note if certain activities exacerbate your discomfort.
2. Physical Therapy: Consider engaging in a structured physical therapy program that focuses on gentle range-of-motion exercises and strengthening to improve mobility. It's essential to work with a therapist who understands your condition.
3. Pain Management: Over-the-counter pain relievers, like ibuprofen or acetaminophen, may help manage pain. Always ensure these are suitable for you given any other medications or conditions.
4. Follow-Up on Blood Work: Since you have elevated inflammatory markers and lupus anticoagulant, ensure you follow up with a rheumatologist or a specialist familiar with autoimmune disorders to assess potential underlying causes for your symptoms.
5. Lifestyle Adjustments: Incorporate gentle stretching and relaxation techniques, like yoga or mindfulness, which can help reduce stiffness and manage pain levels.

If your symptoms worsen or new symptoms arise, such as significant weakness or loss of function, it's important to seek medical attention promptly. Your health is important, and managing these symptoms effectively requires a proactive approach. Please feel free to reach out if you have more questions or need further clarification.