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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What does my MRI scan report indicate?

Answered by
Dr. Priyanka Aggarwal

ENT Specialist

Practicing since :2008

Answered : 1391 Questions

Posted on Tue, 28 Nov 2017 in Ear, Nose and Throat Problems
Question: I have pain near ear/temporal area right side (screen shot will be attached with red line highlighting the approx area where I have pain). I also have tinitus. I feel there is some swelling also in that area compare to the other left side. I am suffering this from last 2 years. MRI is normal.

I think it can be Temporal Arteritis or some other blood vessel related issue.

Can MR Angiogram detect/rule out Temporal Arteritis? Can I ask my doctor to do MRA to rule out Temporal Arteritis after no abnormality detected in MRI? Which MRA should I do MRA (Brain) or MRA (Neck)?

What else could be the reasons for pain in this area?
Answered by Dr. Priyanka Aggarwal 2 hours later
Brief Answer:
Temporal arteritis

Detailed Answer:
Welcome to Healthcare Magic and thanks for putting up the query
From the complaints and as per the site, it appears to be temporal arteritis.
It can be diagnosed by temporal artery biopsy and histopathological examination. You should consult a surgeon for that.
For medical management you can consult a rheumatologist or ENT SPECIALIST. The treatment includes steroids and anti inflammatory drugs.
Any further questions are always welcome.
I hope my advice proves helpful to you.
Take care
Thanks and regards
Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Priyanka Aggarwal 3 hours later

My ESR came normal. Is ESR test result enough to rule out TA? My doctor has put me on Gabapin and Exite tabs for 30 days as hit and trial method assuming some issue with nerve..but I feel it is not the right diagnosis for me..can I ask for doing MRA (angiogram)? Is MRA not at all usefull to detect TA to avoid biopsy because I think biopsy will be painfull and risky procedure as it involves cutting the skin?

Could you please let me know more about the option of MRA and risks involved in Biopsy.
Answered by Dr. Priyanka Aggarwal 20 hours later
Brief Answer:
Temporal pain

Detailed Answer:
Angiogram won't be able to diagnose temporal arteritis. If it is suspected only biopsy should be done. An idea can be made by examination of the area and palpation.
My advice is you should continue with gabapentin and Exite and wait. Even you can ask for an anti inflammatory medication along with this.
ESR may get deranged in later stages or may be even normal in few cases. It only gives an idea but not a confirmatory test but if negative, definitely other differential diagnosis like a neuropathy shiuld be kept in mind.
Biopsy should be kept as the last option.
Any further questions are always welcome.
Wishing you a speedy recovery
Thanks and regards
Above answer was peer-reviewed by : Dr. Nagamani Ng

The User accepted the expert's answer

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