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Hi Experts, I'm Looking For A Differential Diagnosis On A
Question: Hi Experts,
I'm looking for a differential diagnosis on a recent MRI I had. I'm about to go in for a Spinal MRI to assist in diagnosis but, I don't know, it felt extraordinarily "rushed" as an appointment for me to begin with. The running theory is Multiple Sclerosis, I'd just appreciate any input you folks can provide from a brief look at the MRI results that are available online! Will provide my temporarily changed credentials for your review.
Thank you so much in advance!
I'm looking for a differential diagnosis on a recent MRI I had. I'm about to go in for a Spinal MRI to assist in diagnosis but, I don't know, it felt extraordinarily "rushed" as an appointment for me to begin with. The running theory is Multiple Sclerosis, I'd just appreciate any input you folks can provide from a brief look at the MRI results that are available online! Will provide my temporarily changed credentials for your review.
Thank you so much in advance!
Hi Experts,
I'm looking for a differential diagnosis on a recent MRI I had. I'm about to go in for a Spinal MRI to assist in diagnosis but, I don't know, it felt extraordinarily "rushed" as an appointment for me to begin with. The running theory is Multiple Sclerosis, I'd just appreciate any input you folks can provide from a brief look at the MRI results that are available online! Will provide my temporarily changed credentials for your review.
Thank you so much in advance!
I'm looking for a differential diagnosis on a recent MRI I had. I'm about to go in for a Spinal MRI to assist in diagnosis but, I don't know, it felt extraordinarily "rushed" as an appointment for me to begin with. The running theory is Multiple Sclerosis, I'd just appreciate any input you folks can provide from a brief look at the MRI results that are available online! Will provide my temporarily changed credentials for your review.
Thank you so much in advance!
Since the answer has to be peer reviewed, thought I'd skip ahead and just provide you with the login details:
website: https://www.myexamanswers.com/
username: elvenharps
password: Password123$
website: https://www.myexamanswers.com/
username: elvenharps
password: Password123$
Since the answer has to be peer reviewed, thought I'd skip ahead and just provide you with the login details:
website: https://www.myexamanswers.com/
username: elvenharps
password: Password123$
website: https://www.myexamanswers.com/
username: elvenharps
password: Password123$
Brief Answer:
Multiple sclerosis does indeed seem the most likely diagnosis.
Detailed Answer:
Hello and welcome to HealthcareMagic!
I carefully read both MRI reports. Of course diagnosis is not done merely based on imaging findings, some info on your history, symptoms and their evolution in time is necessary, even better if there was a description of the physical neurological exam.
However based on the MRI report alone Multiple Sclerosis (MS) is a very likely diagnosis I am afraid. The report has mentioned neuromyelitis optica as a possible differential diagnosis but the likelihood of that is very low given those lesions (it most commonly affects optic nerve and spine). Other possible diagnoses to be considered would be vasculitis, infections like Lyme disease, vasculitis and Susac syndrome, but again much less likely than MS. However more info on clinical history would be needed as I said.
I remain at your disposal for other questions.
Multiple sclerosis does indeed seem the most likely diagnosis.
Detailed Answer:
Hello and welcome to HealthcareMagic!
I carefully read both MRI reports. Of course diagnosis is not done merely based on imaging findings, some info on your history, symptoms and their evolution in time is necessary, even better if there was a description of the physical neurological exam.
However based on the MRI report alone Multiple Sclerosis (MS) is a very likely diagnosis I am afraid. The report has mentioned neuromyelitis optica as a possible differential diagnosis but the likelihood of that is very low given those lesions (it most commonly affects optic nerve and spine). Other possible diagnoses to be considered would be vasculitis, infections like Lyme disease, vasculitis and Susac syndrome, but again much less likely than MS. However more info on clinical history would be needed as I said.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
Multiple sclerosis does indeed seem the most likely diagnosis.
Detailed Answer:
Hello and welcome to HealthcareMagic!
I carefully read both MRI reports. Of course diagnosis is not done merely based on imaging findings, some info on your history, symptoms and their evolution in time is necessary, even better if there was a description of the physical neurological exam.
However based on the MRI report alone Multiple Sclerosis (MS) is a very likely diagnosis I am afraid. The report has mentioned neuromyelitis optica as a possible differential diagnosis but the likelihood of that is very low given those lesions (it most commonly affects optic nerve and spine). Other possible diagnoses to be considered would be vasculitis, infections like Lyme disease, vasculitis and Susac syndrome, but again much less likely than MS. However more info on clinical history would be needed as I said.
I remain at your disposal for other questions.
Multiple sclerosis does indeed seem the most likely diagnosis.
Detailed Answer:
Hello and welcome to HealthcareMagic!
I carefully read both MRI reports. Of course diagnosis is not done merely based on imaging findings, some info on your history, symptoms and their evolution in time is necessary, even better if there was a description of the physical neurological exam.
However based on the MRI report alone Multiple Sclerosis (MS) is a very likely diagnosis I am afraid. The report has mentioned neuromyelitis optica as a possible differential diagnosis but the likelihood of that is very low given those lesions (it most commonly affects optic nerve and spine). Other possible diagnoses to be considered would be vasculitis, infections like Lyme disease, vasculitis and Susac syndrome, but again much less likely than MS. However more info on clinical history would be needed as I said.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you so much for your prompt response! Were you able to look at the images associated with the report? Just checking that you agree with the original radiologist that performed it!
I had a Spinal MRI today so hopefully that'll allow a better diagnosis. What is interesting, however, is the my blood draws showed a positive "hit" for Anti dsDNA, by EIA. They say that's a positive for ANA. Do such findings go alongside the MRI which you see here?
I had a Spinal MRI today so hopefully that'll allow a better diagnosis. What is interesting, however, is the my blood draws showed a positive "hit" for Anti dsDNA, by EIA. They say that's a positive for ANA. Do such findings go alongside the MRI which you see here?
Thank you so much for your prompt response! Were you able to look at the images associated with the report? Just checking that you agree with the original radiologist that performed it!
I had a Spinal MRI today so hopefully that'll allow a better diagnosis. What is interesting, however, is the my blood draws showed a positive "hit" for Anti dsDNA, by EIA. They say that's a positive for ANA. Do such findings go alongside the MRI which you see here?
I had a Spinal MRI today so hopefully that'll allow a better diagnosis. What is interesting, however, is the my blood draws showed a positive "hit" for Anti dsDNA, by EIA. They say that's a positive for ANA. Do such findings go alongside the MRI which you see here?
Also, the only symptoms I present with currently are odd "hot" sensations in my right-hand index finger. I had been feeling like I was plummeting on a roller coaster when I tilted my head to the left, but that has basically gone away with no treatment aside from voluntary increase of my B12 vitamin levels.
Also, the only symptoms I present with currently are odd "hot" sensations in my right-hand index finger. I had been feeling like I was plummeting on a roller coaster when I tilted my head to the left, but that has basically gone away with no treatment aside from voluntary increase of my B12 vitamin levels.
Brief Answer:
I viewed the images. AntidsDNA can be found in lupus but not alone.
Detailed Answer:
Thank you for the additional information. I hadn’t viewed the images. I had clicked on them but they weren’t opening so I thought they hadn’t been uploaded yet. Only now I retried and noticed that my browser was blocking them. I opened and viewed them now. The images fit with the report however, didn’t notice something new or with which I didn’t agree with.
Considering the little clinical symptoms I understand now why you felt that things were rushed and wanted a confirmation. MS can present with subtle spontaneously improving symptoms with more silent lesions present on MRI though. Maybe the doctor on neurological physical exam noticed some small changes which the patient can’t be aware of and that prompted him/her to request the MRI. The symptoms you describe do correspond to a couple of the lesions, that plummeting feeling to the infratentorial lesion and the abnormal finger sensations to the capsular lesion. There is a dissemination in space and time of both symptoms as well as images which is typical for MS. Given the combination of your age, symptoms and images I still think MS as the most likely diagnosis.
The info about the positive Anti dsDNA does however raise another possibility in the differential diagnosis, that of a connective tissue disease such as lupus. However lupus is a systemic disease involving many systems, most commonly joints, skin, kidneys, heart lung etc. Central nervous system can be involved but usually associated with involvement of other systems. So if there are no other symptoms and findings, a positive Anti dsDNA alone is not enough to make a diagnosis of lupus, it may be slightly elevated even in the absence of disease. If strongly positive though it is something to be considered and kept in mind in order to search more carefully for possible missed signs indicating involvement of other organs.
I viewed the images. AntidsDNA can be found in lupus but not alone.
Detailed Answer:
Thank you for the additional information. I hadn’t viewed the images. I had clicked on them but they weren’t opening so I thought they hadn’t been uploaded yet. Only now I retried and noticed that my browser was blocking them. I opened and viewed them now. The images fit with the report however, didn’t notice something new or with which I didn’t agree with.
Considering the little clinical symptoms I understand now why you felt that things were rushed and wanted a confirmation. MS can present with subtle spontaneously improving symptoms with more silent lesions present on MRI though. Maybe the doctor on neurological physical exam noticed some small changes which the patient can’t be aware of and that prompted him/her to request the MRI. The symptoms you describe do correspond to a couple of the lesions, that plummeting feeling to the infratentorial lesion and the abnormal finger sensations to the capsular lesion. There is a dissemination in space and time of both symptoms as well as images which is typical for MS. Given the combination of your age, symptoms and images I still think MS as the most likely diagnosis.
The info about the positive Anti dsDNA does however raise another possibility in the differential diagnosis, that of a connective tissue disease such as lupus. However lupus is a systemic disease involving many systems, most commonly joints, skin, kidneys, heart lung etc. Central nervous system can be involved but usually associated with involvement of other systems. So if there are no other symptoms and findings, a positive Anti dsDNA alone is not enough to make a diagnosis of lupus, it may be slightly elevated even in the absence of disease. If strongly positive though it is something to be considered and kept in mind in order to search more carefully for possible missed signs indicating involvement of other organs.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
I viewed the images. AntidsDNA can be found in lupus but not alone.
Detailed Answer:
Thank you for the additional information. I hadn’t viewed the images. I had clicked on them but they weren’t opening so I thought they hadn’t been uploaded yet. Only now I retried and noticed that my browser was blocking them. I opened and viewed them now. The images fit with the report however, didn’t notice something new or with which I didn’t agree with.
Considering the little clinical symptoms I understand now why you felt that things were rushed and wanted a confirmation. MS can present with subtle spontaneously improving symptoms with more silent lesions present on MRI though. Maybe the doctor on neurological physical exam noticed some small changes which the patient can’t be aware of and that prompted him/her to request the MRI. The symptoms you describe do correspond to a couple of the lesions, that plummeting feeling to the infratentorial lesion and the abnormal finger sensations to the capsular lesion. There is a dissemination in space and time of both symptoms as well as images which is typical for MS. Given the combination of your age, symptoms and images I still think MS as the most likely diagnosis.
The info about the positive Anti dsDNA does however raise another possibility in the differential diagnosis, that of a connective tissue disease such as lupus. However lupus is a systemic disease involving many systems, most commonly joints, skin, kidneys, heart lung etc. Central nervous system can be involved but usually associated with involvement of other systems. So if there are no other symptoms and findings, a positive Anti dsDNA alone is not enough to make a diagnosis of lupus, it may be slightly elevated even in the absence of disease. If strongly positive though it is something to be considered and kept in mind in order to search more carefully for possible missed signs indicating involvement of other organs.
I viewed the images. AntidsDNA can be found in lupus but not alone.
Detailed Answer:
Thank you for the additional information. I hadn’t viewed the images. I had clicked on them but they weren’t opening so I thought they hadn’t been uploaded yet. Only now I retried and noticed that my browser was blocking them. I opened and viewed them now. The images fit with the report however, didn’t notice something new or with which I didn’t agree with.
Considering the little clinical symptoms I understand now why you felt that things were rushed and wanted a confirmation. MS can present with subtle spontaneously improving symptoms with more silent lesions present on MRI though. Maybe the doctor on neurological physical exam noticed some small changes which the patient can’t be aware of and that prompted him/her to request the MRI. The symptoms you describe do correspond to a couple of the lesions, that plummeting feeling to the infratentorial lesion and the abnormal finger sensations to the capsular lesion. There is a dissemination in space and time of both symptoms as well as images which is typical for MS. Given the combination of your age, symptoms and images I still think MS as the most likely diagnosis.
The info about the positive Anti dsDNA does however raise another possibility in the differential diagnosis, that of a connective tissue disease such as lupus. However lupus is a systemic disease involving many systems, most commonly joints, skin, kidneys, heart lung etc. Central nervous system can be involved but usually associated with involvement of other systems. So if there are no other symptoms and findings, a positive Anti dsDNA alone is not enough to make a diagnosis of lupus, it may be slightly elevated even in the absence of disease. If strongly positive though it is something to be considered and kept in mind in order to search more carefully for possible missed signs indicating involvement of other organs.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you so much! The anti dsNA was only 1 U/mL, so not high at all I believe. No Lupus symptoms are presently prevalent, but the symptoms you discussed above were. Thank you so much for your kind advice!
Thank you so much! The anti dsNA was only 1 U/mL, so not high at all I believe. No Lupus symptoms are presently prevalent, but the symptoms you discussed above were. Thank you so much for your kind advice!
Brief Answer:
You're welcome!
Detailed Answer:
You're welcome, glad to have been of help! Sorry for answering so late, notification email had gone to spam folder for some reason. Fortunately you hadn't written to ask something important.
You're welcome!
Detailed Answer:
You're welcome, glad to have been of help! Sorry for answering so late, notification email had gone to spam folder for some reason. Fortunately you hadn't written to ask something important.
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
You're welcome!
Detailed Answer:
You're welcome, glad to have been of help! Sorry for answering so late, notification email had gone to spam folder for some reason. Fortunately you hadn't written to ask something important.
You're welcome!
Detailed Answer:
You're welcome, glad to have been of help! Sorry for answering so late, notification email had gone to spam folder for some reason. Fortunately you hadn't written to ask something important.
Above answer was peer-reviewed by :
Dr. Kampana
Have been working with a neurologist here and have an appointment with an MS Center on Monday, but wanted to check one quick thing. Does my MRI show any evidence other than lesions? For example: brain tumor, hemorrhage, etc. I just don't know much about understanding the images as they are shown!
Login credentials:
site: https://myexamanswers.com/Account/LogOn?ReturnUrl=%2f
username: elvenharps
password: Password123$
The Brain MRI is the one in question, below the cervical spine, under "View Results".
Thanks!
Oh, I guess also a stroke would be something I am concerned with. These have been reviewed by a Radiologist but I would nonetheless appreciate a second opinion.
Login credentials:
site: https://myexamanswers.com/Account/LogOn?ReturnUrl=%2f
username: elvenharps
password: Password123$
The Brain MRI is the one in question, below the cervical spine, under "View Results".
Thanks!
Oh, I guess also a stroke would be something I am concerned with. These have been reviewed by a Radiologist but I would nonetheless appreciate a second opinion.
Have been working with a neurologist here and have an appointment with an MS Center on Monday, but wanted to check one quick thing. Does my MRI show any evidence other than lesions? For example: brain tumor, hemorrhage, etc. I just don't know much about understanding the images as they are shown!
Login credentials:
site: https://myexamanswers.com/Account/LogOn?ReturnUrl=%2f
username: elvenharps
password: Password123$
The Brain MRI is the one in question, below the cervical spine, under "View Results".
Thanks!
Oh, I guess also a stroke would be something I am concerned with. These have been reviewed by a Radiologist but I would nonetheless appreciate a second opinion.
Login credentials:
site: https://myexamanswers.com/Account/LogOn?ReturnUrl=%2f
username: elvenharps
password: Password123$
The Brain MRI is the one in question, below the cervical spine, under "View Results".
Thanks!
Oh, I guess also a stroke would be something I am concerned with. These have been reviewed by a Radiologist but I would nonetheless appreciate a second opinion.
Brief Answer:
No tumor, hemorrhage or ischemic stroke.
Detailed Answer:
Hello again!
You don't have to worry about a tumor or a stroke (neither a hemorrhagic nor an ischemic one). Those are easily identified on a MRI and there is no indication of that whatsoever, rest assured about that. The differential diagnosis is with inflammatory or infective conditions which I mentioned, no other lesions are in discussion.
Wishing you all the best.
No tumor, hemorrhage or ischemic stroke.
Detailed Answer:
Hello again!
You don't have to worry about a tumor or a stroke (neither a hemorrhagic nor an ischemic one). Those are easily identified on a MRI and there is no indication of that whatsoever, rest assured about that. The differential diagnosis is with inflammatory or infective conditions which I mentioned, no other lesions are in discussion.
Wishing you all the best.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
No tumor, hemorrhage or ischemic stroke.
Detailed Answer:
Hello again!
You don't have to worry about a tumor or a stroke (neither a hemorrhagic nor an ischemic one). Those are easily identified on a MRI and there is no indication of that whatsoever, rest assured about that. The differential diagnosis is with inflammatory or infective conditions which I mentioned, no other lesions are in discussion.
Wishing you all the best.
No tumor, hemorrhage or ischemic stroke.
Detailed Answer:
Hello again!
You don't have to worry about a tumor or a stroke (neither a hemorrhagic nor an ischemic one). Those are easily identified on a MRI and there is no indication of that whatsoever, rest assured about that. The differential diagnosis is with inflammatory or infective conditions which I mentioned, no other lesions are in discussion.
Wishing you all the best.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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