Conflicting MRI Results: Seeking Clarity and Suggestions
I apologize for the lengthy post, but after five years of chronic pain, I feel utterly exhausted by this situation! I’ve been diagnosed with Thoracic Stenosis, along with bone spurs, and I experience intense pain around my ribs lower than the bra line, as well as in my chest, particularly between my shoulder blades and radiating towards my torso. It feels like my chest is burning. I underwent a cervical ACDF procedure on December 24, 2024, and now we’re turning our attention to the thoracic region. I also have two cervical ribs, and my doctor suspects I may be dealing with Thoracic Outlet Syndrome (TOS). A repeat MRI was ordered since the last one was done in 2022, and we're planning an injection in hopes of alleviating some pain before considering surgery. The doctor indicated severe stenosis and bulging in the previous imaging, but the new findings seem inconsistent with what we expected! Please share any insights you might have. Thank you! **First MRI (2022)** **Reason for Exam:** Experiencing weakness in the extremities and middle back discomfort radiating into the chest. **EXAMINATION:** MRI of the Thoracic Spine. **TECHNIQUE:** A multiplanar, multiecho MRI of the thoracic spine was conducted. **FINDINGS:** The spinal cord appears normal in signal and structure. Notable narrowing at the T11-12 region can be attributed partly to ligamentum flavum hypertrophy. There’s an observed curvature (dextrocurvature) of the thoracic spine, with no sign of fractures or dislocations. Some degenerative changes at the endplates have been identified. A specific lesion along the superior endplate of T7 shows increased Tl and T2 signals, with some partial suppression on STIR imaging. There’s no evidence of bony edema, and the adjacent soft tissues look normal. - **T3-4:** Mild disc bulge is causing slight pressure on the anterior thecal sac, but no significant stenosis is evident. - **T4-5:** No disc bulge or protrusions present. - **T5-6:** No disc bulge or protrusions present. - **T6-7:** No disc bulge or protrusions present. - **T7-8:** No disc bulge or protrusions present. - **T8-9:** Mild disc bulge resulting in slight bilateral neural foraminal stenosis, without central canal narrowing. Features of facet arthrosis and mild ligamentum flavum hypertrophy noted. - **T9-10:** Slightly diffuse disc bulge leading to mild bilateral foraminal stenosis, but clearing for central canal. Facet arthrosis and slight thickening of the ligamentum flavum observed. - **T10-11:** General disc bulge is coupled with facet hyperplasia and substantial ligamentum flavum hypertrophy, predominantly on the left, causing mild central canal stenosis measuring 0.83 cm and mild to moderate bilateral foraminal stenosis. - **T11-12:** No disc bulge or protrusions, but facet arthrosis is present. **IMPRESSION:** - No evidence of fractures or dislocations. - Spondylosis and multilevel degenerative disc disease present at T3-4, T9-10, and T10-11, resulting in mild to moderate nerve root constriction and mild central canal narrowing, chiefly at T10-11 due to facet changes and significant ligamentum flavum hypertrophy. - Bony hemangioma located in T7 vertebra. - Dextrocurvature of the thoracic spine noted. **Second MRI** **Study:** MRI Thoracic without contrast **Patient History:** Persistent discomfort between the shoulder blades, extending across the chest since cervical fusion on December 2024; includes numbness in both upper and lower limbs. **Procedure:** Multiplanar, multisequence MR imaging of the thoracic spine was completed without intravenous contrast. **FINDINGS:** Overall vertebral alignment appears normal. The heights of the vertebral bodies and bone marrow signal remain consistent. Intraosseous hemangioma presents in the T7 vertebra. The spinal cord demonstrates a typical signal and contour. There is multilevel degenerative spondylosis and facet joint degeneration. No significant spinal canal constriction or foraminal narrowing has been observed. Adjacent soft tissues remain unremarkable, and the scanned areas of the chest and upper abdomen show no significant findings. **IMPRESSION:** - No notable spinal canal or foraminal stenosis present.
Answers (1)
9/9/2025, 8:50:59 PM
OpenHealth AI
It’s understandable to feel overwhelmed after years of chronic pain, especially with conflicting MRI results. Your situation involves several complex factors, including thoracic stenosis, bone spurs, and potential thoracic outlet syndrome (TOS), which can complicate diagnosis and treatment. Here’s a breakdown of your findings and some steps you can consider:
Main Points:
- Conflicting MRI Results: The first MRI indicated severe stenosis and other issues, while the second MRI shows no significant stenosis.
- Ongoing Symptoms: You are experiencing persistent pain and discomfort, particularly in the chest and back areas.
- Next Steps in Treatment: You’re set to receive an injection for pain relief before any further surgical consideration.
Explanation:
-
Understanding the MRI Results:
- MRI findings can sometimes vary due to changes over time, different imaging techniques, or interpretations. The first MRI highlighted areas of stenosis and degenerative changes, while the second indicated no significant issues.
- This can mean that your body may have experienced some improvement or compensatory changes post-surgery, or it may reflect differences in the imaging process.
-
Chronic Pain Management:
- Chronic pain, especially with your conditions, can lead to a complex interplay between physical and psychological factors. Pain relief and managing symptoms are vital.
Next Steps:
-
Follow-Up Discussion:
- Discuss these conflicting results with your healthcare provider, emphasizing your ongoing pain and any new symptoms (like numbness). Ask about the implications of both MRI results and how they might impact your treatment.
-
Consider Pain Management Techniques:
- Engage in non-invasive pain relief options such as physical therapy, which can strengthen supportive muscles and improve flexibility.
- Consider working with a pain specialist who can explore options like nerve blocks or targeted injections.
-
Symptom Tracking:
- Maintain a daily log of your symptoms, including pain levels, locations, and any activities that aggravate or relieve them. This information can be invaluable for your next appointment to refine your treatment plan.
-
Explore Lifestyle Modifications:
- Focus on ergonomic adjustments at work or home to reduce strain on your thoracic spine. Gentle exercises or stretches can help improve mobility and reduce pain—preferably guided by a physical therapist.
-
Stay Informed About TOS:
- Since your doctor suspects TOS, familiarize yourself with its symptoms and management options. This may include specific exercises and postural changes that can alleviate discomfort.
-
Prioritize Mental Well-Being:
- Chronic pain can affect mental health. Consider speaking to a counselor or psychologist who specializes in pain management for coping strategies that can aid your situation.
Conclusion:
Navigating chronic pain and conflicting medical information can be daunting. Stay proactive about your healthcare communication, explore comprehensive pain management options, and engage in self-care practices that promote your physical and emotional well-being. Remember, you are not alone in this; support is available to help you through your recovery journey. If you have more questions or need further guidance, feel free to ask!
Related Questions
Experiencing Heart Palpitations Following Chest Impact
I'm a 17-year-old female who has struggled with tachycardia for several years, having been diagnosed with postural tachycardia syndrome (POTS) about five years ago, although I haven't pursued further testing because I haven't completely lost consciousness. Recently, over the past month or two, I've started to experience sensations of my heart skipping beats, accompanied by difficulty in breathing during these episodes. These occurrences have become significantly more frequent, even when I'm at rest. Five years ago, I underwent a Holter monitor test, which indicated primarily tachycardia with occasional premature ventricular contractions (PVCs), but nothing alarming was found. In early December, I was struck hard in the chest by an elbow while in a mosh pit, which resulted in some pain when taking deep breaths for a few days. My sternum became bruised and slightly swollen, and it remained tender to touch for about two weeks, but this discomfort was manageable. I still feel some soreness when stretching, although it’s not severe. Additionally, I have diagnoses of Crohn’s disease and hypermobile Ehlers-Danlos syndrome (HEDS), and I am currently on immunosuppressants. Given these circumstances, would it be advisable for me to seek medical evaluation, or could these symptoms be considered typical?
Post-Gallbladder Surgery Concerns: Potential Infection Three Weeks Later?
Subject's Age: 35 Gender: Female Height: 5 feet 4 inches Weight: 160 pounds Ethnicity: Asian Duration of Symptoms: Last Three Weeks Geographic Location: United States Relevant Medical History: Almost three weeks ago, I underwent gallbladder removal surgery. In the last few days, I have observed a small amount of cloudy discharge emerging from my incision site. Recently, I noticed what appears to be pus leaking from the area. While there is no significant pain, I do feel a mild soreness when I touch or move the site. I have not experienced any fever or chills, and there’s no unpleasant odor coming from the wound. Should I continue to clean the area with soap and water, or is it advisable to seek medical attention at the emergency room for further evaluation?
Understanding My Experiences with Dissociation and Physical Symptoms
Hello everyone! I'm 15 years old and I’ve been grappling with intense feelings of dissociation recently. About two years back, I experienced what I now refer to as a "silent seizure" for the first time. It happened around 2 PM while I was at school in the band hall. Suddenly, I found myself zoning out completely; I was just sitting there, disassociated from reality, until it dawned on me that I couldn’t seem to reconnect with my surroundings. Feeling lost, I turned to a friend and anxiously asked, "Where am I?" She chuckled, unaware of the seriousness of my situation, but I stood up and wandered out of the classroom, aimlessly walking towards the bathrooms. The sensation was akin to being in a dream—you know you’re somewhere, yet you can’t fully engage with the moment for what felt like 5 to 10 minutes. Strangely, I even had the feeling of observing myself from above as I moved through the halls, like a scene from a dream. In a state of panic, I contacted my mom. By the time I managed to leave school, my mind was clearing. She took me to her workplace where a colleague checked my blood sugar levels, revealing it was low. I had eaten that day, so this was unexpected (especially since my mother also faces issues with low blood sugar). This occurrence was unprecedented for me; thankfully, I haven’t faced such low levels since then. In the following weeks, I experienced intermittent dissociative episodes, prompting me to visit a doctor. I underwent blood tests, an electrocardiogram (EKG), and a routine examination. Everything appeared normal, except I was diagnosed with anemia—something my mother and sister also deal with. I walked away from that appointment without any real explanations, and after a while, the episodes subsided—thankfully, a relief. FAST FORWARD TO NOW: (15 years old) (Potentially relevant context) Recently, I’ve been enduring severe heart and chest discomfort. I’ve been noticing irregular heartbeats, sporadic strong pulsations, and sharp pain localized in my heart region and upper right chest. Lying on my side can be quite painful, and sometimes I struggle to take deep breaths. I make it a priority to get a full eight hours of sleep each night, I take daily vitamins, and I’m actively involved in competitive cheerleading, maintaining a healthy fitness level for my height and weight. We sought medical advice again, underwent numerous tests, and, once more, everything checked out fine. My heart was deemed healthy, and all other measurements were satisfactory. Initially, we suspected anxiety might be a factor, but my mom is hesitant to consider antidepressants, believing that my age may limit treatment options. She has recommended that I hydrate more and practice breathing exercises (which is somewhat ironic since I struggle to breathe when these pains occur, yet I don’t argue). UPDATE: During practice today, I unexpectedly experienced my first "silent seizure" episode in two years. It was more disconcerting than I recalled. I lost track of my location again and couldn’t re-engage with reality. It felt as if I was observing those around me from a dream-like vantage point. This realization frightened me, thinking that I had moved past these episodes. It took about ten minutes for me to regain my awareness of my environment. Additionally, this week, I noticed moments of dissociation, albeit not as intense as previous episodes. I found myself vacantly staring, and my vision felt oddly lazy, frequently. It's worth noting that I do not have a lazy eye. I plan to document these occurrences meticulously, and if they persist, I will consult my doctor again. Meanwhile, if anyone has suggestions about what might be happening to me, I would greatly appreciate it. Is this potentially linked to anxiety? I’m genuinely confused about my condition!
Seeking Insight on Abnormal Neuroimaging Results
A 42-year-old female, standing 6 feet tall and weighing 194 pounds, has been grappling with cognitive challenges for over three years. She has a clinical history that includes a diagnosis of Bipolar II disorder coupled with generalized anxiety, which she manages effectively through a regimen of an antidepressant, a mood stabilizer, and medications for anxiety. Currently, she is under the care of her fifth neurologist in the Boston region. An FDG-PET scan revealed a significant decline in metabolic functions, showing a 30-40% reduction within the left parietal lobe and a 20% decrease in both mesial temporal lobes. As part of her evaluation, a lumbar puncture was performed to assess amyloid and tau protein levels, with results coming back negative. Although a radiologist recommended pursuing an amyloid PET scan to gain further insights, her neurologist has declined this option. Despite the neurologist's suggestion that her indications might fit into the Functional Neurological Disorder (FND) category, she remains unconvinced and believes there must be an identifiable underlying cause for her symptoms and the irregularities observed in her scans. She is seeking advice on the next steps to take in pursuing a clearer diagnosis or understanding of her condition.
Worsening Memory Problems Over Time
Age: 25 Weight: 175 lbs Current Medications: Modafinil (200mg); Lexapro (10 mg); Lamotrigine (100mg in the morning + 100 mg in the evening); Cyproheptadine (4 mg); Vraylar (1.5 mg) Supplements: Iron; Vitamin B12; Vitamin D; Salt tablets Health Background: Long-standing, stubborn migraines (resolved as of May 2025, originally began in April 2016); Depression (currently very stable); Attention Deficit Disorder (ADD) (experimented with various stimulants with no improvement in memory); Chronic fatigue syndrome (developed a few years after memory problems began). I possess a documented medical history concerning my memory challenges. Around 2012, I underwent neurological evaluations that included an IQ assessment. The clinician indicated that my memory performance was particularly low, affecting my overall IQ representation, while I scored at or above average in most other areas. In approximately 2017, a neurologist referred me for a neuropsychological evaluation. Unfortunately, the results were deemed "inconclusive" due to inconsistent findings, with the provider stating my memory levels mirrored the previously reported low scores. Fast forward to 2023, when I underwent another neuropsych evaluation, which indicated my working memory was significantly below the average range. The clinician expressed uncertainty regarding effective treatment options for my memory issues, suggesting avenues such as ADHD medications, stress management, enhancing sleep quality, and mental health support—areas which I have pursued or tried to improve. Here is a summary of the strategies and treatments I've explored: - **Sleep Study**: Diagnosed with mild sleep apnea when lying on my back, although I typically sleep in other positions. - **Antidepressants**: Tried various types repeatedly, yet without noticing any significant changes. - **Occupational Therapy**: Participated but found it more stressful than beneficial. - **Speech Therapy**: Benefitted somewhat, yet it didn't meet my expectations, though I continue to use some of the techniques learned. - **Digital Notes**: Attempted to record important information on my phone, but due to many lists, vital entries often get lost. - **Memantine**: Prescribed by my neurologist as a last resort, based on its reported effectiveness in elderly patients for pain management; however, I did not observe any memory improvements while on this medication. - **Nutritional Supplements**: Regularly take Vitamin B complex, fish oil, flaxseed oil, and various other potential memory enhancers. Additionally, family history reveals that my brother, sister, and paternal grandmother have also faced memory-related issues throughout their lives. Unfortunately, several neurologists have declined to treat me, citing my youth and existing diagnoses of depression and ADD as indicators of instability rather than addressing my memory concerns. Moreover, I am anxious that my past struggles with chronic pain could have exacerbated my memory problems. Any insights or suggestions to tackle these ongoing challenges would be greatly appreciated.