I don't understand my MRI spine imaging

Posted by sb4ca @sb4ca, Sep 13, 2023

I’ve recently had a big uptick in neck and upper shoulder pain and saw my surgeon. The very end of December I had my third ACDF so I’m accustomed to looking at MRI images but only the sagittal versions make sense to me. He ordered an MRI which was done end of last week and the images are now available on the portal. The actual body of the vertebrae where I had the ACDF, C3-4, now shows a very dark infiltration that I’ve never seen on any MRI. The area is considered hypo intense. Comparing to The MRI prior to that surgery there is a radiology note that new bone marrow edema was present in those same vertebrae. Now they are almost completely obliterated in the T1 mode. The portal also changed the date of the report availability by 4 days So yes I’m scared. I’m wondering if it’s infected since I had a revision surgery last year too for osteomyelitis with MRSA. I do have a primary immune deficiency. This is completely unexpected and I did get a hard lymph node on the left side of my neck. The surgeon said let’s see what shows in the MRI. God I just remembered that

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I'm impressed you can read an MRI. They always hand me the CD to take to my doctor the same day but I can't even get it uploaded. I have to wait 24 hours to go back and get a printed copy of the radiologist report. I can't wait for the doctors office to upload it to their portal, I'd have too much anxiety. I trust their reports thoroughly since that is their focus of education. What does the radiologist report say? I hope it's good news for you. Best regards.
Alex

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I would try to not get too concerned at this point until you discuss this with the doc that ordered the MRI. Besides, what good does worying do at this point in time. It's probably something that is easily explained. Let your docs do their job.

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Has anyone ever had a radiologist read your MRI wrong? I just had an MRI done because I had a fast onset of significant pain. For history I’ve had 2 ACDF’s C3/4 on 12/30/22 and on 3/2022 had fusion of C5-7 plus a revision of C5-7 due to osteomyelitis. So the new MRI was done on a machine with software to reduce metal artifacts. The report was surprising because it lacked the details that are normally seen on MRI The difference is stunning. The radiologist stated I had gone through ACDF on C4-5 which I’ve not had done. The images look exactly like the images done prior to ACDF 3-4. Very curious if anyone has had this type of thing happen and how it ended. My surgeon reads MRI himself so I’m not too concerned with it

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@sb4ca I am a spine fusion patient. Don't worry too much about the imaging you see. Your surgeon can read it and explain it to you. I think you may be seeing the shadowing caused by metal spine hardware because it does look very dark. If something like a PEEK (type of plastic) cage is used, that is considered radiolucent because it does not cast a shadow on the MRI. Often there are metal plates attached to the front of the spine. Don't put this pressure on yourself because you are not trained in radiology.

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@sb4ca

Has anyone ever had a radiologist read your MRI wrong? I just had an MRI done because I had a fast onset of significant pain. For history I’ve had 2 ACDF’s C3/4 on 12/30/22 and on 3/2022 had fusion of C5-7 plus a revision of C5-7 due to osteomyelitis. So the new MRI was done on a machine with software to reduce metal artifacts. The report was surprising because it lacked the details that are normally seen on MRI The difference is stunning. The radiologist stated I had gone through ACDF on C4-5 which I’ve not had done. The images look exactly like the images done prior to ACDF 3-4. Very curious if anyone has had this type of thing happen and how it ended. My surgeon reads MRI himself so I’m not too concerned with it

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I had an MRI done some time around 2010 and radiologist reported nothing wrong. I finally got to a new doctor and he looked at it along with a radiologist inn his office and he said I had arachnoiditis. In 2020 I had another one done and. The same thing happened again. The new ortho doctor said it was arachnoiditis and it was 5 levels of scar tissue. MRI’s are supposed to be the best it’s just the radiologist that I have a problem with. If the doctor can see it why can’t he. Something is wrong.

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@sb4ca

Has anyone ever had a radiologist read your MRI wrong? I just had an MRI done because I had a fast onset of significant pain. For history I’ve had 2 ACDF’s C3/4 on 12/30/22 and on 3/2022 had fusion of C5-7 plus a revision of C5-7 due to osteomyelitis. So the new MRI was done on a machine with software to reduce metal artifacts. The report was surprising because it lacked the details that are normally seen on MRI The difference is stunning. The radiologist stated I had gone through ACDF on C4-5 which I’ve not had done. The images look exactly like the images done prior to ACDF 3-4. Very curious if anyone has had this type of thing happen and how it ended. My surgeon reads MRI himself so I’m not too concerned with it

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bad2thebone, this is a valuable warning for us. MRI has a 97 or 99% accuracy for reading arachnoiditis. Is there good treatment? Do you know the cause? Usually orthopedists are trained to read MRIs, but many mds rely on the radiolo gist. Twice, though. This must be a common oversight. I appreciate your post.

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@sb4ca

Has anyone ever had a radiologist read your MRI wrong? I just had an MRI done because I had a fast onset of significant pain. For history I’ve had 2 ACDF’s C3/4 on 12/30/22 and on 3/2022 had fusion of C5-7 plus a revision of C5-7 due to osteomyelitis. So the new MRI was done on a machine with software to reduce metal artifacts. The report was surprising because it lacked the details that are normally seen on MRI The difference is stunning. The radiologist stated I had gone through ACDF on C4-5 which I’ve not had done. The images look exactly like the images done prior to ACDF 3-4. Very curious if anyone has had this type of thing happen and how it ended. My surgeon reads MRI himself so I’m not too concerned with it

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Nice of you to bring this to our attention. Could you MD see it on the new MRI? Will you contact the radiologist?
Thank you

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@gently

Nice of you to bring this to our attention. Could you MD see it on the new MRI? Will you contact the radiologist?
Thank you

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I had surgery to fuse where an artificial disc had been put in 4 years earlier. Doctor said new disc got loose and was breaking off bone fragments and he thought he had it all cleaned up. Sent me home on OxyContin. He knew it was bad. Had rods and screws put in and artificial disc stayed in also. Well it looks like something got into the spinal canal sack and dug into the arachnoid membrane that helps protect the nerves and now there is 5 lower levels filled with scar tissue.. there is nobody can fix or treat this because if they try to remove the scar tissue it only creates more. With all the surgery in that area I have been told I would only have a 50/50 chance of coming off of the operating table alive because there is no way to see the blood vessels. My pain doctor only reads radiologist report and I had to get him to look at Ortho doctors report to get him to understand I have the Arachnoiditis. He still says he is not sure. I saw the MRI at the Orthopedic doctors office and he showed me the difference on different levels of my spine. You could not miss this unless you were blind.
I am going to let him know he needs to go back and look at mine and maybe a lot others he has read to see how wrong he has been.

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@bad2thebone

I had surgery to fuse where an artificial disc had been put in 4 years earlier. Doctor said new disc got loose and was breaking off bone fragments and he thought he had it all cleaned up. Sent me home on OxyContin. He knew it was bad. Had rods and screws put in and artificial disc stayed in also. Well it looks like something got into the spinal canal sack and dug into the arachnoid membrane that helps protect the nerves and now there is 5 lower levels filled with scar tissue.. there is nobody can fix or treat this because if they try to remove the scar tissue it only creates more. With all the surgery in that area I have been told I would only have a 50/50 chance of coming off of the operating table alive because there is no way to see the blood vessels. My pain doctor only reads radiologist report and I had to get him to look at Ortho doctors report to get him to understand I have the Arachnoiditis. He still says he is not sure. I saw the MRI at the Orthopedic doctors office and he showed me the difference on different levels of my spine. You could not miss this unless you were blind.
I am going to let him know he needs to go back and look at mine and maybe a lot others he has read to see how wrong he has been.

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@bad2thebone I would advise caution if you are going to point out mistakes to a doctor. That may get some adverse comments put into your medical record and because records are shared between hospital systems on Epic, perhaps all your doctors will see it and it will reflect badly on you, the patient. A doctor does not have to accept you as their patient. You can fire a doctor and they can fire a patient. Anyone can make a mistake, but you also have to consider that doctors are entitled to their opinions because they are trained experts and most patients do not have their level of training and qualifications. They are licensed to provide a diagnosis and without those advanced medical degrees, a patient is not. Often doctors vary in their opinions anyway and interpretation of imaging can vary a lot depending on what they are looking for when they view it. It is much better to talk about it here and remain anonymous. It is better to have good relationships with physicians and that will lead to better and more accurate care for you. If you go down a rabbit hole with a disagreement, that can distract the provider from thinking about the right care for you. If you advocate for yourself by asking good questions, you'll get better responses from your providers.

I'll give you an example in my experience. 5 spine surgeons missed my correct diagnosis. All of them could read the MRI and see that there was a disc osteophyte complex pressing into my spinal cord, and I could understand the MRI and see that too because I have a biology degree and understand a lot about anatomy, but not the same degree of detail as a doctor learns. They missed my diagnosis because my symptoms didn't match their expectations from my imaging. I found cases like mine in medical literature, and with that information, I came to Mayo and had surgery with a surgeon who understood that type of "rare" case. I did later send that literature to one of the surgeons who missed it and I was kind. I did that to share information and let him know that I had successful surgery that resolved the problem which was the only way to prove that my symptoms were related to the correct diagnosis. I made sure that I only shared the knowledge from my surgeon and not my own opinion because I did not want to make any accusations. He is a smart enough guy and will understand that he missed it. I never heard from him after that and perhaps his people may not have given him my letter.

At first, I tried to get my other doctors at the same medical center to help me address this with the surgeon who had missed it, and no one would help because they would not challenge the opinion of a specialist who was a leader and directer of a spine center. Their advice to me was to seek another opinion elsewhere, and that is when I came to Mayo.

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@sb4ca

Has anyone ever had a radiologist read your MRI wrong? I just had an MRI done because I had a fast onset of significant pain. For history I’ve had 2 ACDF’s C3/4 on 12/30/22 and on 3/2022 had fusion of C5-7 plus a revision of C5-7 due to osteomyelitis. So the new MRI was done on a machine with software to reduce metal artifacts. The report was surprising because it lacked the details that are normally seen on MRI The difference is stunning. The radiologist stated I had gone through ACDF on C4-5 which I’ve not had done. The images look exactly like the images done prior to ACDF 3-4. Very curious if anyone has had this type of thing happen and how it ended. My surgeon reads MRI himself so I’m not too concerned with it

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Hello @sb4ca. I noticed you had started another discussion on the same topic, so you will see that I have moved this post here now, and I've updated the original title to help bring in other members:
- I don't understand my MRI spine imaging: https://connect.mayoclinic.org/discussion/now-im-scared-mri/

I see you've had several members join you to give you reassurance about the images themselves. When will you receive feedback from your doctor?

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