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MRI report depicting anaemia or bone marrow infiltrative disorder - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2407 Questions
Doctor :   Hi
Doctor :  
How can i help you?
User :   I am severely stressed about my MRI results and no one is open
User :   I saw my family doctor yesterday and do not know what to think
User :   are you a specialist?
Doctor :   ok
Doctor :   let me no what is your concern about the MRI report
Doctor :  
i shall help you in this
User :   I had a two lumbar MRIs one last year and one this December for ongoing severe sciatica. They found a mild hyperintensity on bone marrow which signals they said either anemia or bone marrow infiltrative disorder
Doctor :   ok

User :   blood work came back normal but no anemia and now being referred to oncologist for further test running. Doctor was looking at multiple myeloma and I am only 35 but tests are negative so far but not anemic which doesn't explain MRI results
User :   worried sick
User :   have you ever seen this on MRI without it being something serious? Internet is no help
Doctor :   internet is of help to provide you information and not for the diagnosis

User :   I know but I would think I could find other diagnosis or people that have had similar issues and have found none
Doctor :   diagnosis is to be made by the doctor and not by yourself
Doctor :   every disease do not present with same complaint in everyone
Doctor :  
and many different diseases will have same type of presentation
Doctor :  
so dont get confused
Doctor :  
now provide me some more detail of the MRI report
User :   marrow signal is normal and no stenosis etc, bilateral facet arthropathy only
User :   I don't have report in front of me but I can go downstairs and get it if it helps
Doctor :   ok
User :   mild arthropathy I've had bad back pain for over a year on and off. And now I just want to know if there are cases where people have this and it is nothing or is it always something when MRI shows hyperintensity on bone marrow
Doctor :   hyperintense in the marrow is because of increase in the infiltration of the white blood cells
Doctor :   and it can happen even in trauma
Doctor :  
Doctor :  
Doctor :  
infilteration with the tumor cells
Doctor :   so it needs to be co related with the clinical symptoms
Doctor :  
why was the MRI suggested?
User :   by pain management doctor
User :   because of slip and fall accident a year ago but this is a specialist I was referred to because nothing helped with pain not physical therapy
Doctor :   ok
User :   I pulled MRI report and says mild marrow hypoitensity is identified on T-1 Weighted images diffusely within lumbar spine which is non-specific
Doctor :  
User :   mild bilateral facet arthropathy at L5-S1 no narrowing or canal stenosis
Doctor :  
User :   so you are telling me that this could happen from the accident or from the back pain (my inflammation rate came up somewhat high in bloodwork) but that's it
Doctor :  
there is arthropathy in the facet joint
User :   yes
Doctor :  
meaning there is infiltration activity
User :   it says mild
User :   can this happen from an accident or just from age? The sciatica is getting so bad I do not sleep and very depressed trying to take care of 3 kids working and stressing on this
Doctor :   the accident has caused the joint to go for arthropaty - traumatic arthropathy
Doctor :   so the spine is unable to take up the weight and is pressing on the nerve
Doctor :  
causing the pain
User :   can that happen in a short period of time? A couple months or a year? They said the MRI was unchanged since comparison and first MRI was done two months after accident and second one was done one year after accident
Doctor :  
yes it can happen.
Doctor :   presently what has been suggested for the pain? are your doctors do planing for any surgical procedure?
User :   ok so from what you are saying that maybe the accident or the joint pain is causing the hypointensity?
User :   I haven't been evaluated yet for surgery, just gave me darvocet which didn't help after 5 days of not sleeping I went to ER for pain meds/morphine it was that bad because I couldn't sleep -- also referred to hemotologist for further evaluation and referral to possible neurosurgeon and to have further tests done
User :   I also have follow up with pain management for next week but really just stressing on the fact that dr. said more testing may be needed
User :   for the myeloma
User :   but my family dr said this is precautionary and up to the oncologist etc
Doctor :   ok
Doctor :   yes

User :   Did you say yes as to the accident being possible cause for hypointensity? I wasn't sure
Doctor :   yes it could be one of the possibility
User :   do you think it would have shown up for sure in blood if it was cancer or tumor?
Doctor :   cancer will not show up in blood during routine work up
User :   doctor specifically tested for it
Doctor :   if it is so and than it is negative than yes the blood work up will give a clue
User :   my family doctor /lab did work up on metabolic panel, electrophoresis, sed rate, etc
User :   is the only real way to tell is to have biopsy? or is bloodwork pretty acurate?
Doctor :   biopsy is the confirmatory test

Doctor :   blood work up and clinical symptom and MRI and other radiological tests give a clue to the diagnosis
User :   so if it were you what would you do?
Doctor :   the blood work is normal and the MRI is the one showing some lesion
Doctor :   and it is non specific
Doctor :  
that is the report
Doctor :  
so i would employed the technique of wait and watch
User :   so would you have the biopsy or ask for it, ask for another MRI?
User :   or wait to see what oncologist recommends?
Doctor :   i really don't know why oncologist is been recomended
Doctor :  
your basic problem is the traumatic arthropathy
Doctor :  
that needs to be addressed and the sciatica pain needs to be resolved
User :   my dr said the hemotologist may say why are you here and I was hoping that would be the case
User :   Who would i see for that a spine specialist? Rhemotologist?
Doctor :   as you said blood work up is normal than why hematologist?

User :   but the myeloma guess was scaring the hell out of me once i read up on it.
User :   True
User :   maybe precautionary?
Doctor :   precautionary for what when the report is normal

Doctor :  
so i do recommend that the spine should be evaluated by the orthopaedician or neurosurgeon
Doctor :   get rid of the pain
Doctor :   as you have read in net about the symptoms of myeloma
Doctor :   do you think those symptoms are there in you?
User :   yes I agree the pain is the worst but now I am only thinking of cancer and stressing maybe needlessly
User :   easily bruising, yes. Tired - sometimes, frequent urination yes but I have history of bladder infections and dr. said urine showed bladder infection. Other than that I don't know.
User :   but I have always easily bruised to a point
User :   They said herpes virus is common in myeloma and I have always had canker sores so I guess you read into things
User :   however absolutely no cancer runs in my family except for one grandma got stomach cancer at 87 probably from age
Doctor :   canker sore the other name is stress ulcer

User :   yes...I have a lot right now because of braces but have always had those since 5 years old
Doctor :   yes it is the stress of any kind may be physical or emotional in some it will come soon
Doctor :   so once you think you are suffering from myeloma or cancer or something like that than you will stress yourself and it will cause increase in the cancket sore appearence
Doctor :  
any ways the symptoms you narrated do not fit into to make a diagnosis of myeloma and or cancer
Doctor :   so relax
Doctor :  
don't get worried by reading what is given in net
Doctor :   lets concentrate on the lesion in the back which appeared after trauma
Doctor :   and causing the ongoing pain and suffering
User :   ok thank you so much
User :   are you a family physician?
Doctor :  
neurosurgeon or orthopedician will be better to evaluate the spine and provide you the appropriate treatment for the pain relief
Doctor :  
yes i am
Doctor :  
after consulting them you can come back to us for further discussion and to know what would be best for you
User :   alright I appreciate I feel like I got more out of you than I did yesterday
Doctor :  
please fill the feed back form
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