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What does my X-ray test result indicate?

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Posted on Tue, 24 May 2016
Question: Hi. I am 50 years old and in relatively good health. However, I have advanced degenerative disc disease in my cervical spine, along with moderate to severe arthritis from C5-7

I was recently also diagnosed with psoriatic arthritis.

I just had an X-ray of my upper arm because I have severe pain there, usually at night but sometimes in the day. My X-ray report says "long segment cortical thinning of the lateral proximal to mid humoral diaphysis"

What does this indicate? Is this what's causing my severe upper arm pain?

I have not had an injury, nor do I smoke
doctor
Answered by Dr. Vivek Chail (49 minutes later)
Brief Answer:
The outer layer is humerus bone is thinned out and is probably weak

Detailed Answer:
Hi,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. The x ray shows that the bone in your arm shows that the outer layer of the humerus bone called cortex has thinned out in the upper two thirds shaft on its outer part. This can happen when there is osteopenia and the bone is weak. If possible then please upload your x ray picture for better interpretation of your problem.

2. There can be many reasons for osteopenia including psoriasis, metabolic causes and neoplasia. Since you have psoriasis, therefore this point is to be discussed in detail with your doctor and further detailed imaging might be required.

3. Your arm pain can have multiple causes. Cervical degenerative changes can cause arm pain due to pinching of nerve roots supplying the area. From the x ray the bone looks weak. In addition, you have psoriatic arthritis.

In conclusion, the humerus is showing changes which are compatible with bone weakening and which can cause the arm pain. The pain can be intensified due to the existing cervical degenerative changes.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Vivek Chail (38 minutes later)
Thank you for your insight. I will be seeing my rheumatologist next week but I wanted to have an answer now and be prepared for next week.

Could the thinning indicate RA? My mother has RA but not psoriatic arthritis. I'm curious if the arm's none thinning could be a symptom of RA or possibly a lesion or tumor.

When it hurts, the pain is horrible. But it is not that level pain all the time. It's the worse at night

doctor
Answered by Dr. Vivek Chail (54 minutes later)
Brief Answer:
Many conditions including RA can cause cortical thinning

Detailed Answer:
Hi,
Thanks for writing back with an update.

1. Cortical thinning can be seen in RA but again there are many conditions which can cause it. However your doctor might run few laboratory tests to check your calcium metabolism and arthritis specific test.

2. Any abnormal finding is called a lesion. So you have a bone lesion which is extending over two thirds of upper shaft humerus on outer part and is probably diffuse. The description is of a diffuse lesion. Tumor word is not mentioned and tumors are usually focal. Therefore a tumor is less likely.

3. Pain in the night is a non specific symptoms keeping in mind your x ray findings. For that matter even osteopenia does not cause significant pain until there is some stress on the bone.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6820 Questions

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What does my X-ray test result indicate?

Brief Answer: The outer layer is humerus bone is thinned out and is probably weak Detailed Answer: Hi, Thanks for writing in to us. I have read through your query in detail. Please find my observations below. 1. The x ray shows that the bone in your arm shows that the outer layer of the humerus bone called cortex has thinned out in the upper two thirds shaft on its outer part. This can happen when there is osteopenia and the bone is weak. If possible then please upload your x ray picture for better interpretation of your problem. 2. There can be many reasons for osteopenia including psoriasis, metabolic causes and neoplasia. Since you have psoriasis, therefore this point is to be discussed in detail with your doctor and further detailed imaging might be required. 3. Your arm pain can have multiple causes. Cervical degenerative changes can cause arm pain due to pinching of nerve roots supplying the area. From the x ray the bone looks weak. In addition, you have psoriatic arthritis. In conclusion, the humerus is showing changes which are compatible with bone weakening and which can cause the arm pain. The pain can be intensified due to the existing cervical degenerative changes. Hope your query is answered. Please do write back if you have any doubts. Regards,