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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Want explanation of MRI report. Have central disc protrusion, asymmetric disc bulge. Are these causing upper back pain?

Answered by
Dr.
Dr. Sudhir

Internal Medicine Specialist

Practicing since :2000

Answered : 1415 Questions

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Posted on Sat, 25 Aug 2012 in Back Pain
Question: I have questions about my MRI of my thoracic spine done 1/8/10.
There are tiny foci of abnormal signal within a few vertebrae including T5 and T11. The foci seem to supress on STIR. These could represent atypical hemangiomas. Also at T7-T8 a aysymmetric disc bulge which mildly effaces the thecal sac and comes close to contact the cord. On MRI of 7/15/11 this place appears to make contact with the spinal cord. I also have a broad based right cental disc protrusion at T4-T5. Can you explain these findings I have attached the MRI report from 1/8/10 and can they be a cause of my upper back pain?
doctor
Answered by Dr. Sudhir 4 hours later
Hello,

Thanks for the question.

Unfortunately the file you have uploaded as MRI report is second page of report and it doesn't have your report.
But information in your question is sufficient enough to explain the primary cause of your symptoms.
The vertebral hemangiomas are common symptom-less finding, so you should not worry about them. They don't progress or cause any symptoms. Many times these are incidental finding. So don't worry about them.
There is space containing fluid between normal vertebral discs and spinal cord. When discs bulge or protrude, they encroach this space before coming in contact with spinal cord or nerves. And in later stages when cord or nerve get compressed you start experiencing symptoms.
T7-8 disc bulge might have increased and it is now in contact with spinal cord or maybe it is compressing cord even. Generally in such situation such disc bulges also compress the nerve roots coming out of spinal cord. And this causes back pain.
Disc protrusion occurs when outer annular ligament, which keeps disc in place is torn. This leads to protrusion of disc material into spinal canal. And even this can cause compression of spinal nerves leading to pain along path of nerve.

So at the moment both of these disc issues are causing you symptoms.

Please ask if there are doubts.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir 37 hours later
Thank you for your reply. I have only wanted to know whether the disc protrusions and the appearance of the atypical hemangiaomas have been the cause. I do not want surgery.

My follow up question is that an MRI of my thoracic spine was done in Feb. 2003 and there were no foci, hemangiaomas or lesions shown on that MRI and then when I had the MRI of my thoracic spine on 1/8/10 the foci or what appear to be atypical hemangiaomas were there. What caused them to grow in that period of time and what is to keep them from continuing to grow and how do I know for sure that they are atypical hemangiaomas and not something else?
Thank you for your help.
doctor
Answered by Dr. Sudhir 10 hours later
Hello,

Disc protrusion can be the cause of symptoms.But atypical hemangiomas won't cause symptoms.

1.It's not known why such hemangiomas appear , nor there is any thing you can do to stop them from appearing or growing.Such hemangiomas are never treated.
2.To confirm that they are hemangiomas few investigations like - MRI with contrast,bone scan and PET scan can be undertaken.Other approach is to get a follow up MRI done to see interval change. And if any of these investigations arises suspicion of anything else then a biopsy can be considered.But it is less likely that you will need biopsy.

Hope that answers your question.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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