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Symptoms Of Rheumatoid Arthritis Or Other Inflammatory Arthropathy
Question: Hi, I have had an EMG which showed chronic Radiculopathy in C5, C7-C8 and well as Sacral area chronic Radiculopathy. I just had a lumbar spinal fusion on L5-S1 1.5 months ago , Where it was found in surgery that I had severe narrowing,even though the MRI showed only mild stenosis. Dr performed Laminectomy,as well as fusion. I was in 2 motor vehicle accidents. 1 rear end in November 2022, which resulted in the Spinal Fusion, and the other rear end in May 2023, which is causing all this neck pain.
My MRI results is listed below. Can you please tell me what this means? I'm only 41 years old. I have tingling,numbness, shocking pain in all 4 limbs, and sometimes feel like I'm stepping on a wet sponge. When I turnmy neck now,it sounds like sand or a salt/pepper shaker grinding, and there's tons of pain.
MR Cervical Spine without Contrast -
Details
Study Result
IMPRESSION:
1. Trace fluid in the left atlantooccipital articulation could relate
to mild capsuloligamentous injury or abnormal motion. There is no
fracture or high-grade ligamentous injury in the cervical spine.
2. Overall mild degenerative changes without significant spinal canal
or neural foraminal stenosis most pronounced at C5-C6.
Narrative
MRI OF THE CERVICAL SPINE WITHOUT INTRAVENOUS CONTRAST
EXAM DATE AND TIME: 9/14/2023 10:41 MDT
INDICATION: MVC.
TECHNIQUE: Multiplanar, multisequence MRI of the cervical spine was
performed.
COMPARISON: 5/17/2023
FINDINGS:
ALIGNMENT: Minimal anterolisthesis of C4 on C5, C5 on C6.
BONE: No aggressive osseous lesion identified. Vertebral body heights
are preserved. Diffuse marrow T1 signal hypointensity without
discrete lesion.
CORD: No substantial cord signal or size abnormality.
EXTRA-AXIAL: There are no epidural collections.
OTHER: No suspicious paraspinal soft tissue lesions identified.
DEGENERATIVE:
C1-2: No substantial spinal or neural foraminal narrowing. Trace
fluid in the left atlantooccipital articulation which could relate to
mild capsuloligamentous injury or abnormal motion.
C2-3: No substantial spinal or neural foraminal narrowing.
C3-4: Mild disc osteophyte complex partially effaces the ventral CSF
column. Patent spinal canal. Minimal uncovertebral hypertrophy
without significant neural foraminal narrowing.
C4-5: Disc osteophyte complex without significant spinal canal
narrowing. Uncovertebral hypertrophy and facet arthrosis on the right
without neural foraminal narrowing.
C5-6: Disc ossify complex partially effaces the ventral CSF column
and flattens the ventral cord without cord signal change. Mild spinal
canal narrowing. Uncovertebral hypertrophy and facet arthrosis
bilaterally without significant neural foraminal narrowing.
C6-7: No substantial spinal or neural foraminal narrowing.
C7-T1: No substantial spinal or neural foraminal narrowing.
My MRI results is listed below. Can you please tell me what this means? I'm only 41 years old. I have tingling,numbness, shocking pain in all 4 limbs, and sometimes feel like I'm stepping on a wet sponge. When I turnmy neck now,it sounds like sand or a salt/pepper shaker grinding, and there's tons of pain.
MR Cervical Spine without Contrast -
Details
Study Result
IMPRESSION:
1. Trace fluid in the left atlantooccipital articulation could relate
to mild capsuloligamentous injury or abnormal motion. There is no
fracture or high-grade ligamentous injury in the cervical spine.
2. Overall mild degenerative changes without significant spinal canal
or neural foraminal stenosis most pronounced at C5-C6.
Narrative
MRI OF THE CERVICAL SPINE WITHOUT INTRAVENOUS CONTRAST
EXAM DATE AND TIME: 9/14/2023 10:41 MDT
INDICATION: MVC.
TECHNIQUE: Multiplanar, multisequence MRI of the cervical spine was
performed.
COMPARISON: 5/17/2023
FINDINGS:
ALIGNMENT: Minimal anterolisthesis of C4 on C5, C5 on C6.
BONE: No aggressive osseous lesion identified. Vertebral body heights
are preserved. Diffuse marrow T1 signal hypointensity without
discrete lesion.
CORD: No substantial cord signal or size abnormality.
EXTRA-AXIAL: There are no epidural collections.
OTHER: No suspicious paraspinal soft tissue lesions identified.
DEGENERATIVE:
C1-2: No substantial spinal or neural foraminal narrowing. Trace
fluid in the left atlantooccipital articulation which could relate to
mild capsuloligamentous injury or abnormal motion.
C2-3: No substantial spinal or neural foraminal narrowing.
C3-4: Mild disc osteophyte complex partially effaces the ventral CSF
column. Patent spinal canal. Minimal uncovertebral hypertrophy
without significant neural foraminal narrowing.
C4-5: Disc osteophyte complex without significant spinal canal
narrowing. Uncovertebral hypertrophy and facet arthrosis on the right
without neural foraminal narrowing.
C5-6: Disc ossify complex partially effaces the ventral CSF column
and flattens the ventral cord without cord signal change. Mild spinal
canal narrowing. Uncovertebral hypertrophy and facet arthrosis
bilaterally without significant neural foraminal narrowing.
C6-7: No substantial spinal or neural foraminal narrowing.
C7-T1: No substantial spinal or neural foraminal narrowing.
Brief Answer:
Answer
Detailed Answer:
Hi there.
Thanks for the query.
I have read your query and understood your question. As per your EMG and MRI reports, it appears that you do have some sort of instability at the C1 – C2 vertebral junction. This may be related to possible trauma, Rheumatoid arthritis or other inflammatory arthropathy. You also have a disc at C5-C6, which is mildly touching the covering of your spinal cord but not compressing any of the nerves yet.
If you have headaches and neck pain then this could be a cause. It would be best to discuss with a Neurosurgeon as the best deal with C1-C2 junction problems.
I hope I have answered your query. I will be available for follow-up queries.
Thanking you.
Kind regards.
Aashish Raghu
Answer
Detailed Answer:
Hi there.
Thanks for the query.
I have read your query and understood your question. As per your EMG and MRI reports, it appears that you do have some sort of instability at the C1 – C2 vertebral junction. This may be related to possible trauma, Rheumatoid arthritis or other inflammatory arthropathy. You also have a disc at C5-C6, which is mildly touching the covering of your spinal cord but not compressing any of the nerves yet.
If you have headaches and neck pain then this could be a cause. It would be best to discuss with a Neurosurgeon as the best deal with C1-C2 junction problems.
I hope I have answered your query. I will be available for follow-up queries.
Thanking you.
Kind regards.
Aashish Raghu
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I had a previous neck mri 4 months ago that showed normal, besides a few bone spurs. I also see that I have something wrong with my bone marrow that looked fine in May. Why is if showing that now, is that from the trauma too?
Brief Answer:
need to have T1 STIR MRI sequence to differentiate the causes
Detailed Answer:
Hi there
Diffuse marrow T1 signal is difficult to interpret and ideally you’ll need to have T1 STIR MRI sequence to differentiate the causes such as bone cancer, cancer metastasis to bone, inflammatory bone disorders like Gout, Sarcoidoisis, Myelofibrosis
need to have T1 STIR MRI sequence to differentiate the causes
Detailed Answer:
Hi there
Diffuse marrow T1 signal is difficult to interpret and ideally you’ll need to have T1 STIR MRI sequence to differentiate the causes such as bone cancer, cancer metastasis to bone, inflammatory bone disorders like Gout, Sarcoidoisis, Myelofibrosis
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I also haven't felt my left foot,up to mid length of my leg in 3 days now. I'm used to strange neuropathy in my legs, but this feels different. It almost feels like it's in a blood pressure cuff when I walk
Brief Answer:
Full spine MRI may be required
Detailed Answer:
Hi there.
Thanks for the query.
If you do have separate symptoms of leg numbness or weakness, it would be advisable to have a whole spine MRI, because there can be compression of your nerves in the lower back lumbar spine as well, which can coincidently occur with compression of nerves in your neck in about 10% cases.
You can have multiple neuropathy, especially in diabetes, hypothyroidism, or other causes of peripheral neuropathy. Have you performed EMG or nerve conduction studies of your lower limbs?
Full spine MRI may be required
Detailed Answer:
Hi there.
Thanks for the query.
If you do have separate symptoms of leg numbness or weakness, it would be advisable to have a whole spine MRI, because there can be compression of your nerves in the lower back lumbar spine as well, which can coincidently occur with compression of nerves in your neck in about 10% cases.
You can have multiple neuropathy, especially in diabetes, hypothyroidism, or other causes of peripheral neuropathy. Have you performed EMG or nerve conduction studies of your lower limbs?
Above answer was peer-reviewed by :
Dr. Kampana
Yes, it came back chronic radiculopathy in C5,C7-C8 upper extremities, and sacral area Radiculopathy-lower limbs( but I just had a spinal fusion Alif/MI PlifL5-S1
Brief Answer:
Atlantooccital injury
Detailed Answer:
Thanks for letting me know.
Your neck symptoms are most likely due to inflammation of left Atlantoaxial joint as per fluid in the joint as per MRI. I suggest a period of rest in a cervical collar to see if this subside. There are no sinister findings in the neck that warrants any surgical treatment at this stage.
Atlantooccital injury
Detailed Answer:
Thanks for letting me know.
Your neck symptoms are most likely due to inflammation of left Atlantoaxial joint as per fluid in the joint as per MRI. I suggest a period of rest in a cervical collar to see if this subside. There are no sinister findings in the neck that warrants any surgical treatment at this stage.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Kampana
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