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M.r.i. results
Jan 20, 2011
Hello every one, this is my first time posting,and i was wondering if anyone could give me there thoughts on the following m.r.i report for cervical spine.Some loss of normal cervical lordosis noted.Moderate degenerative changes with narrowing and loss of signal intensity together with osteophyte formation seen at c5-c6 and c6-c7 levels.Associated oa changes seen in the facet joints at those 2 levels.Mild posterior and broad-based disc bulge seen at c5-c6 level and the combination of this mild disc bulge with the degenerative changes at this level caused some encroachment on both exit foramina and with no significant stenosis.Slight posterior and left sided disc bulge seen at c6-c7 level which caused some encroachment on the left exit foramina with no significant stenosis..I also have high readings for c.r.p and sed rate.But rheumy tthinks its unlikely i have ra, althought he has said i have seronegetive arthritis .I also have severe lumber pain ,thumb pain ,knee and foot pain[ball of foot] and siatica in both sides of my bottom.My blood platlets were quite high also.At the moment the worst pain is in my neck, any thoughts on where i should go from here? im on plaquenil,and m.s.t.Thank you in advance of any answers.
Re: M.r.i. results
Jan 20, 2011
I can give you some insight into your problems as I happen to have both OA and RA and have my cervical spine fused from C3 to T1.

Let's start with the arthritis stuff. Sero negative arthritis means you have something starting but the blood tests are currently negative except to show you have definite inflammation(sed rate and CRP). RA can be sero negative but with RA, the only areas of the spine it generally affects is the top 2 vertebrae....C1 and 2. RA eats into the bone whereas OA builds bone in the wrong place. They can see the difference in x-rays and other imaging tests.

Osteoarthritis is primarily what affects the spine. That said, there are a number of different kinds of arthritis that are inflammatory with arthritis that looks identical to OA in MRI's and x-rays and CT's. So even though they may eventually diagnose you with something in particular, for all intents and purposes, you have OA.

It is very possible to have both OA and an inflammatory arthritis.

Now to your spine and the cervical MRI. A little anatomy. The spinal cord starts just above C1. It goes down through the vertebrae(it's toward the back of the vertebra), inside the bone. A spongy disk acts as a cushion between the vertebra and it is towards the front of the vertebra. When they do an MRI, they give the results as between the vertebrae as that is where the trouble usually is...the disks. As we get older, they tend to dry out and rupture and if they rupture backwards toward the spinal cord area, they can cause a lot of trouble by pressing both on spinal nerves that exit the cord to the body, and the spinal cord itself.

At each vertebra, a pair of spinal nerves peels off the cord and leaves the spinal canal through an opening known as a foramina(one of the left and one on the right). A bad disk along with the bone spurs of OA, can end up pressing on these nerves and causing a lot of pain.

So here's your results..........At C5-6 and C6-7, they can see osteophytes(bone spurs) have formed on the vertebrae and on the facet area on the back side of the vertebrae that helps with stabilizing the neck when you twist it. At C5-6, these bone spurs along with a ruptured disk are causing pressure on the spinal nerves that go to the body but no pressure on the spinal cord. At C6-7, you have a similar problem but this time the major problem is on the left side and not both sides. Again, your spinal cord is fine.

In both cases, they have rated the amount of pressure as "mild" on a scale that uses, minimal, mild, moderate, and severe so you are a 2 on a scale of 1-4. Most docs won't operate until you are in the 3-4 range.

That comment on the loss of cervical lordosis means that your neck has gone slightly straight and that is normal with age as well as with arthritis.

You mention you lumbar pain and sciatica you have.....has anyone done x-rays to see if you have arthritis in the sacro-iliac joints of your pelvis? There is an entire group of inflammatory disorders that have spinal arthritis along with arthritis in the SI joints. And they are sero-negative. And they are treatable.

Plaquenil is a pretty good first line drug for whatever you have. I'm not sure what m.s.t. is.....does that have a full name? We may have a different name here in the US.

Either way, your neck is not bad but it probably hurts. You are no where near any kind of permanent damage. Once they figure out exactly what you have, they will probably be able to give you stronger meds to slow down the damage.

What is it? The 3 most common "sero negative spondyloarthropathies"(sero negative inflammatory arthritis with spine and SI joint involvement) are Psoriatic Arthritis(do you have any kind of skin rash?), Anklylosing Spondylitis(like OA but hits the spine very badly) and Reactive Arthritis(follows an infection like an STD or food poisoning). My bet would be one of those 3. All are treatable and Reactive arthritis may be curable according to new studies.

You must have questions...ask away. That is why we are here.

gentle hugs..................Jenny

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