OpenHealth Q&A

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:

1. Conflicting MRI Results: The first MRI indicated severe stenosis and other issues, while the second MRI shows no significant stenosis.
2. Ongoing Symptoms: You are experiencing persistent pain and discomfort, particularly in the chest and back areas.
3. Next Steps in Treatment: You’re set to receive an injection for pain relief before any further surgical consideration.

Explanation:

1. 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.

2. 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:

1. 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.

2. 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.

3. 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.

4. 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.

5. 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.

6. 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!