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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For A Problem In The Spine

Hi, i was wondering how often a Syrinx of the spine is often misdiagnosed. I was told by an orthopedic, neurologist and a neruosergon that I have a syrinx in my spine. When I moved at the beginning of this year I was getting looked at by my orthopedic here and after looking at my MRI he said he doesnt see one at all and that it happened that people are misdiagnosed. Its hard to know who is right because Im not a doctor. When I look at my MRI and look at images online of what I should see I cant see anything that looks like a Syrinx. Thoughts?
Fri, 21 Nov 2014
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Neurologist,  's  Response
Hello dear,
First of all,my reassurance for you.We, the doctors,treat the patients and not the MRI's.The very basic of a clinical practice is to correlate the clinical symptoms and signs of patients with investigations.In fact,in the older days,when there were no MRI's,patients used to be diagnosed accurately with precise clinical skills of the doctor.Investigations are meant just to supplement the clinical findings and not to replace the clinical history and examination of the patient.Coming on to syrinx in MRI-the appearance of syrinx is a linear slit like hyperintense signal in MRI spine,which is to be correlated for sure with the clinical findings of the patient like limb weakness,atrophy or thinning of the limb,fasciculations.In absence of any of these,or in a completely normal individual,I would rather say it has more chances to be some artifact,if at all is there.Many hyperintense signals in MRI's dont have any clinical relevance.Just to mention,30 percent of normal brain MRI's have hyperintense signals,that doesn't mean,we start treating every normal person for nothing he has got.One question-why were you visiting ortho surgeon?One tip for your reassurance-Please visit a neurologist and get examined yourself,if any problem.I hope it helped.
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Suggest Treatment For A Problem In The Spine

Hello dear, First of all,my reassurance for you.We, the doctors,treat the patients and not the MRI s.The very basic of a clinical practice is to correlate the clinical symptoms and signs of patients with investigations.In fact,in the older days,when there were no MRI s,patients used to be diagnosed accurately with precise clinical skills of the doctor.Investigations are meant just to supplement the clinical findings and not to replace the clinical history and examination of the patient.Coming on to syrinx in MRI-the appearance of syrinx is a linear slit like hyperintense signal in MRI spine,which is to be correlated for sure with the clinical findings of the patient like limb weakness,atrophy or thinning of the limb,fasciculations.In absence of any of these,or in a completely normal individual,I would rather say it has more chances to be some artifact,if at all is there.Many hyperintense signals in MRI s dont have any clinical relevance.Just to mention,30 percent of normal brain MRI s have hyperintense signals,that doesn t mean,we start treating every normal person for nothing he has got.One question-why were you visiting ortho surgeon?One tip for your reassurance-Please visit a neurologist and get examined yourself,if any problem.I hope it helped.