Rut Roh Rorge - PSA wrong direction

I guess my RO wasn't kidding when he said, "Stat". Lumbar MRI ordered this morning, completed this afternoon, results posted this evening.
_____________________________________________
Impression:

Osseous metastatic disease replaces the marrow of the L5 vertebral body. More diffuse marrow heterogeneity is noted which is likely related to diffuse marrow infiltration.

No significant spinal canal stenosis is noted in the lumbar region. Please see additional comments above.

Procedure: MR LUMBAR SPINE W WO CONTRAST

History: 70-year-old patient with L5 metastatic disease.

There are 5 lumbar type vertebral bodies noted.

Findings:

Diffuse marrow replacement is identified in the L5 vertebral body. This is consistent with osseous metastatic disease. No significant epidural component is demonstrated. Diffuse heterogeneous marrow signal suspicious for marrow infiltration is noted throughout the lumbar spine and sacral region.

No compression deformities are noted. The distal spinal cord and conus is of normal signal intensity.

Broad-based disc bulges are present at all levels in the lumbar region. A superimposed central disc protrusion is noted at L2-L3. A superimposed LEFT paracentral disc protrusion is noted at L4-L5.

Moderate bilateral foraminal narrowing is noted at L5-S1.
___________________________________________________________

I'll reserve any speculation until I hear from RO other than to say, this report is no bueno. Apparently, there's a reason my back hurts.

@mjp0512 If it is limited to L5, that can be spot radiated. My husband had metastases in L5 and that is what was done to destroy them.

I guess my RO wasn't kidding when he said, "Stat". Lumbar MRI ordered this morning, completed this afternoon, results posted this evening.
_____________________________________________
Impression:

Osseous metastatic disease replaces the marrow of the L5 vertebral body. More diffuse marrow heterogeneity is noted which is likely related to diffuse marrow infiltration.

No significant spinal canal stenosis is noted in the lumbar region. Please see additional comments above.

Procedure: MR LUMBAR SPINE W WO CONTRAST

History: 70-year-old patient with L5 metastatic disease.

There are 5 lumbar type vertebral bodies noted.

Findings:

Diffuse marrow replacement is identified in the L5 vertebral body. This is consistent with osseous metastatic disease. No significant epidural component is demonstrated. Diffuse heterogeneous marrow signal suspicious for marrow infiltration is noted throughout the lumbar spine and sacral region.

No compression deformities are noted. The distal spinal cord and conus is of normal signal intensity.

Broad-based disc bulges are present at all levels in the lumbar region. A superimposed central disc protrusion is noted at L2-L3. A superimposed LEFT paracentral disc protrusion is noted at L4-L5.

Moderate bilateral foraminal narrowing is noted at L5-S1.
___________________________________________________________

I'll reserve any speculation until I hear from RO other than to say, this report is no bueno. Apparently, there's a reason my back hurts.

Got another call from RO. SBRT to L5 recommended. Probably 2 sessions but he'll know for sure once he gets me on the table for targeting.

As far as the other "Diffuse heterogeneous marrow signal" I was concerned with; he feels it is most likely age-related sclerotic degeneration and not that much different from a lumbar MRI I had 3 years ago. Additionally, he said that if it was metastatic disease, he would expect my ALP to be 3 or 4 times what it is.

So... scheduling will call tomorrow to set up SBRT targeting and treatment dates. Hope it works and I can sleep through the night for a change.

@mjp0512
Oh, what a relief 👍 !
Two zaps ⚡️ and it will be gone ! I am so happy for you mjp, I know that you once wrote that you are not worrying type but it must feel good to know that fix is straightforward and easy - yeayyy !!! : ))))

Let us know when will zapping happen so that we can send "good vibes" your way < 3. May that also prove to be a cure for your lumbar pain 🍀 !

Got another call from RO. SBRT to L5 recommended. Probably 2 sessions but he'll know for sure once he gets me on the table for targeting.

As far as the other "Diffuse heterogeneous marrow signal" I was concerned with; he feels it is most likely age-related sclerotic degeneration and not that much different from a lumbar MRI I had 3 years ago. Additionally, he said that if it was metastatic disease, he would expect my ALP to be 3 or 4 times what it is.

So... scheduling will call tomorrow to set up SBRT targeting and treatment dates. Hope it works and I can sleep through the night for a change.

Wow, this guy is not messing around. SBRT simulation scheduled for tomorrow.

Diagnostic MRI, results, and SBRT simulation in less than a week? Wonder if he bought a new boat or something that he has to pay off? 🤣🤣🤣