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Analysis of MRI scan of lumbar and pelvis for back pain - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Back Pain
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
Doctor :   Hi
Doctor :  
How can i help you?
User :   I had a slip and fall accident over a year ago. Have severe sciatica type pain on right side and is irritating to the point I don't sleep. I've had 6 mos physical therapy that did nothing, painkillers which I can't function on and have 3 children. I've had 3 MRIs two of lumbar which at first appeared to be normal over a year ago to one year later stating I had mild marrow hypointensity on T1 weighted images and could have marrow infiltrative disorder so I freaked out when they started running all sorts of cancer tests for multiple myeoma which turned out okay and I did not have cancer. Also showed mild bilateral facet arthropathy at L5-S1 unchanged since last MRI. Xrays showed sclerosis presumably degenerative at SI joints left greater than right. Pelvis MRI recently showed some subcortical sclerotic change in left iliac bone in left side nothing in right. Why is my right side hurting is this attributed to accident ? or will they say due to prefall? I didnt have pain pre-fall
Doctor :  
Let me read through the paragraph.
User :   I would like to know what is a subcortical sclerotic change in left iliac bone because I haven't reviewed the 3rd MRI with my Doctor because he is on vacation but had the report faxed to me
Doctor :   cortex refers to the outer part of the bone.
User :   right but what does that phrase mean on my MRI
Doctor :  
A subcortical sclerosis refers to a degenerative changes that occurs just below this level.
User :   is there anything to do for it, why is all the pain on my right side and is this all to due with age or is it from my fall?
Doctor :  
The cause for this however cannot be predicted now.
Doctor :  
It would require studies on your blood.
User :   all my blood work from cancer tests and regular tests came back normal as well as urine
Doctor :  
It might occur due to infection, a trauma or as suggested by your doctors
User :   is there separate tests for this? Is it anything to be concerned about?
User :   would this cause sciatica on right side? they did not find any disc problems. and also wondering why the marrow is being infiltrated with nothing showing in my blood
Doctor :   We would like to see previous reports too

Doctor :  
Before concluding on the cause for it.
User :   This started in 10/08 before this I never had an MRI nor any xrays
User :   I had one MRI 12/08 and xrays and another lumbar MRI 12/09 and pelvis MRI last week
Doctor :   May i know your age and gender?
User :   are you a spine specialist or a general practitioner? I am female 36
Doctor :  
I am a general practioner.
User :   Could this be something serious or just back pain?
User :   I also want to know for my legal matter against where I fell if this can in any way be possible that it happened as a result of the fall?
Doctor :   The pain might be due to the changes that have been noticed in the MRI, but the cause for these changes can be decided after investigations.
User :   after what investigations?
User :   I have all of my MRI reports one page each 3 separate ones and my xray reports
Doctor :   MRI is done to know if there are any structural problems.
User :   so what else would you suggest that I have done?
Doctor :   may i know what other blood tests have been done?
User :   I had full blood work up I believe for cancer and other bloodwork done for life insurance I think there may have been a little high on inflammation or something but every single test has come back normal
Doctor :   Would it be possible to mail us those reports to us.
User :   basic metabolic panel, glucose, creatinine, protein, electrophoresis, sed rate etc
User :   how would I do that?
Doctor :  
You can scan the reports and send it to YYYY@YYYY
Doctor :  
Alternatively you can take a second opinion by a spine surgeon too if you want to.
Doctor :  
Would you be interested in doing that.
User :   yes
Doctor :   If you are interested in a second opinion with a spine surgeon, then we would cancel this chat payment and direct it to the payment for the second opinion.
User :   ok is that via email or via chat
Doctor :   You can either get an opinion over the phone or through the email, the choice would be yours.
User :   how do I get one via email?
Doctor :   Just a minute.
Doctor :   You need to click on this link, WWW.WWWW.WW User :   and do what?
Doctor :   You will be directed to the second opinion from a spine surgeon in our panel
Doctor :  
Doctor :   Also mention the problems on write your health query page
Doctor :  
Send the scanned reports of the blood tests and the MRI reports to YYYY@YYYY and mention for second opinion too in the mail.
Doctor :  
Have you followed?
Doctor :  
This would cost you 29usd and the payment for this chat would be refunded back to you.
Doctor :   Have you followed?
Doctor :  
It seems you have moved out of the chat window. Please log in back if you have medical queries.
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