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MRI results showed Lumbar spine, conus lies at L1-2 and abnormal T1 marrow. What does this indicate?

DOCTOR OF THE MONTH - May 2014
May 2014
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MRI RESULTS LUMBAR SPINE.WOMAN 38 YEARS OLD
THE CONUS LIES AT L1-2.NORMAL SIGNAL FROM THE CORD.NO ABNORMAL T1 MARROW REPLACEMENT WITHIN THE LUMBAR VERTEBRAL BODIES ON T1-WEIGHTED IMAGING.ANTEROSUPERIOR ENDPLATE INFRACTION OF THE L2 VERTEBRAL BODY.NO ACUTE FRACTURE ON STIR IMAGING.MULTILEVEL DEGENERATIVE CHANGES ARE EVIDENT.INCOMPLETELY VISUALISED AND ASSESSED DISC AT T9-10.
CENTRAL DISC BULGES AT10-11 AND T11-12.NO DEDICATED AXIAL IMAGING PERFORMED THROUGH THESE LEVELS.AT L4-5 THERE IS BROAD-BASED CENTRAL AND LEFT CENTRAL DISC BULGE EFFACING THE TECAL SAC.MILD LEFT NEURAL FORAMINAL STENOSIS.
AT L5-S1 THERE IS A BROAD-BASED CENTRAL AND LEFT CENTRAL DISC BULGE EFFACTING THE THECAL SAC.NO SIGNIFICANT NEURAL FORAMINAL ENCROACHMENT.
THE REMAINING LUMBAR LEVELS SHOW NO SIGNIFICANT DISC EXTRUSION OR PROTRUSION,NO SIGNIFICANT CANAL STENOSIS AND NO SIGNIFICANT NEURAL FORAMINAL ENCROACHMENT.
Posted Thu, 15 Aug 2013 in X-ray, Lab tests and Scans
 
 
Answered by Dr. Vivek Chail 2 hours later
Hi XXXXX,
Thanks for writing in.

I suppose you are a 38 years old woman who got a MRI scan of dorsolumbar spine probably for back pain.

This is Dr Vivek, radiologist and I will try to explain your MRI details in simple language.

1. THE CONUS LIES AT L1-2.NORMAL SIGNAL FROM THE CORD.
This means that the lower end of your spinal cord is at level of L2 vertebra. This is a normal finding.

2. NO ABNORMAL T1 MARROW REPLACEMENT WITHIN THE LUMBAR VERTEBRAL BODIES.
There bone marrow in the small bones of the spine show normal features for your age. This is a normal finding.

3. ON T1-WEIGHTED IMAGING.ANTEROSUPERIOR ENDPLATE INFRACTION OF THE L2 VERTEBRAL BODY.
There is mild degenerative change seen in L2 vertebral bone at its upper surface. This is a sign of early degenerative change.

4. NO ACUTE FRACTURE ON STIR IMAGING.MULTILEVEL DEGENERATIVE CHANGES ARE EVIDENT.
There is no fracture of any of the small bone but degenerative changes are seen at few levels involving the discs (cushion like entities between two bones).

5. INCOMPLETELY VISUALISED AND ASSESSED DISC AT T9-10.
The disc at level T9 - T10 is not completely visualized. I suppose this is a technical observation stating that the disc at T9 - T 10 was partially imaged.

6. CENTRAL DISC BULGES AT10-11 AND T11-12.NO DEDICATED AXIAL IMAGING PERFORMED THROUGH THESE LEVELS.
The discs at levels T10 - T11 and T11 - T12 are showing bulge centrally. This may be due to wear and tear.

7. AT L4-5 THERE IS BROAD-BASED CENTRAL AND LEFT CENTRAL DISC BULGE EFFACING THE TECAL SAC.MILD LEFT NEURAL FORAMINAL STENOSIS.
There is a significant disc bulge involving the L4 - L5 disc. The disc bulge is also extending towards the left posterior. This is causing pressure on the hole through which the nerve root is passing. This can cause pain.

8. AT L5-S1 THERE IS A BROAD-BASED CENTRAL AND LEFT CENTRAL DISC BULGE EFFACTING THE THECAL SAC.NO SIGNIFICANT NEURAL FORAMINAL ENCROACHMENT.
In disc at level L5 - S1 there is a bulge, which is classified as central in appearance, a degenerative change. Posteriorly it is touching the sac covering the spinal cord (thecal sac). It is not causing any pressure on the nerve roots.

9. THE REMAINING LUMBAR LEVELS SHOW NO SIGNIFICANT DISC EXTRUSION OR PROTRUSION,NO SIGNIFICANT CANAL STENOSIS AND NO SIGNIFICANT NEURAL FORAMINAL ENCROACHMENT.
Rest of the imaged spine shows normal features.

Hope your queries are answered.
Should there be any further queries, please feel free to ask.

Wishing you good health.

Regards
Dr Vivek
Above answer was peer-reviewed by
 
Follow-up: MRI results showed Lumbar spine, conus lies at L1-2 and abnormal T1 marrow. What does this indicate? 52 minutes later
HOW DO YOU THINK THE ORTOPEDIC DOCTOR CAN DO SOMETHING WITH THAT?
FHIZJOTHERAPY NOT HELP .
MY BIG PROBLEM IS IF IM WORKING( ALL DAY STAY IM GENERAL OPERATOR-MAKE SANDWICHES) PROBLEMS ARE BACK.....I HAVE A BIG PAIN FROM BACK,THE TABLETS( DIFINE 75MG 2 TABLETS TWICE DAYLY NOT HELP).SOMETHIMES THE PRESURE FROM BACK IS TO HIGH AND I CANT REALY WALK OR EVEN STAY....MOVEMENT ARS AS LITLE...
I HAVE A PROBLEM WITH KNEE
THIS IS A MRI RESULTS
I HAD ARTHROSCPIC SURGERY 3 TIMES INCLUDING TRANSPLANT OF BONE AND CARTILAGE

NO JOINT EFFUSION.NO BAKERS CYST.

IN THE PATELLOFEMORAL COMPARTMENT,THERE IS FOCAL ADVANCED CHONDROMALACIA ON THE MEDIAL FACET OF THE PATELLAR.THIS IS A RELATIVELY SMALL AREA.
THE OTHER ANTERIOS STRUCTURES IN THE KNEE APPEAR NORMAL.

IN THE MEDIAL COMPARTMENT OF THE KNEE,THE IS A FOCAL OSTEOCHONDRAL ABNORMALITY IN THE CENTRAL WEIGHTBEARING SURFACE ON THE FEMORAL CONDYLE.THE SURFACE OF CORTILAGE APPEARS TO BE INTACT,ALTHOUGH SLIGHTLY IRREGULAR.THE MENISCUS AND CORTILAGE OTHERWISE APPEARS IN THE MEDIAL COMPARTMENT.

IN THE LATERAL COMPARTMENT OF THE KNEE,THE MENISCUS AND CARTILAGE APPEARS NORMAL.

THE ANTERIOR CRUCIATE LIGAMENT AND OTHER LIGAMENTS AND SOFT TISSUES APPEARS NORMAL.

IMPRESSION- SATISFACTORY APPERANCE OF THE OSTEOCHONDRAL TRANSPLANT AND THE MEDIAL FEMORAL CONDYLE.THERE IS A VERY SMALL AREA OF CHONDROMALACIA ON THE MEDIAL EDGE OF THE PATELLA.

??????
 
 
Answered by Dr. Vivek Chail 4 hours later
Hi XXXXX,
Thanks for writing in.

You could get started by taking regular breaks at work if permitted, to provide rest to your back. Avoid carrying heavy weight and moving your lower back spine suddenly. Light physiotherapy exercises may be of help. Difene 75 mg is a good preparation for pain relief, if it seems not to be working, you may need to take additional medications in consultation with your doctor for neuropathic pain.

Coming to your MRI scan knee,
1.     NO JOINT EFFUSION.NO BAKERS CYST.
No fluid or cyst is noted in the knee joint space.

2.     IN THE PATELLOFEMORAL COMPARTMENT,THERE IS FOCAL ADVANCED CHONDROMALACIA ON THE MEDIAL FACET OF THE PATELLAR.THIS IS A RELATIVELY SMALL AREA.
THE OTHER ANTERIOS STRUCTURES IN THE KNEE APPEAR NORMAL.
There is a small area in the patella where there is chondromalacia (benign finding).

3.     IN THE MEDIAL COMPARTMENT OF THE KNEE,THE IS A FOCAL OSTEOCHONDRAL ABNORMALITY IN THE CENTRAL WEIGHTBEARING SURFACE ON THE FEMORAL CONDYLE.THE SURFACE OF CORTILAGE APPEARS TO BE INTACT,ALTHOUGH SLIGHTLY IRREGULAR.THE MENISCUS AND CORTILAGE OTHERWISE APPEARS IN THE MEDIAL COMPARTMENT.
Minor degenerative cartilage changes are noted in the central part of lower surface of femur. The inner compartment of knee joint otherwise appears normal.

4.     IN THE LATERAL COMPARTMENT OF THE KNEE,THE MENISCUS AND CARTILAGE APPEARS NORMAL.
The outer compartment of knee joint is normal.

5.     THE ANTERIOR CRUCIATE LIGAMENT AND OTHER LIGAMENTS AND SOFT TISSUES APPEARS NORMAL
The anterior cruciate ligament, posterior cruciate and medial/ lateral condylar ligaments with muscles are normal.

6.     IMPRESSION- SATISFACTORY APPERANCE OF THE OSTEOCHONDRAL TRANSPLANT AND THE MEDIAL FEMORAL CONDYLE.THERE IS A VERY SMALL AREA OF CHONDROMALACIA ON THE MEDIAL EDGE OF THE PATELLA.
Impression: The appearance of osteochondral (bone cartilage) transplant is acceptable. Small area of patella shows chondromalacia.

Hope your queries are answered.

Wishing you good health.

Regards
Dr Vivek
Above answer was peer-reviewed by
 
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