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Re: Newest MRI...
Jun 26, 2012
Hi Sandy ~

Sometimes I think patients should not read written radiology reports unless their doctor is available to explain it in detail. There is too much chance for anxiety when only knowing part of the story!

Lesion is a term that is frequently used in MRIs of the spine and usually sounds more scary than it really is....A lesion is any type of "abnormality" this case the radiologist sees well-defined lesions that are showing up in the vertebral body of Thoracic 2 and Thoracic 5 vertebrae. Then it states [B]Lesions are hyperintense on the t2 sequence with multiple punctate foci of low signal.[/B] Basically this means that there are spots showing up in the vertebrae. Since the other vertebrae do not have spots, this is an "abnormal" finding that should be brought to the doctor's attention.

T1 and T2 refer to the way the MRI machine is set up to take the images.
T2 weighted images are best for visualizing Degenerative Disc Disease. This is because the T2 image shows off watery structures as bright white and shows off desiccated regions (areas with low fluid concentrations) as black.

There is a possibility that the finding of lesions is significant and might be a sign that something is wrong, or it may mean nothing. I'm afraid you'll have to wait until you meet with the spine specialist to find out for sure.

The rest of the MRI indicates that you have some signs of degenerate disc issues in many of the cervical discs. The healthy disc contains a high percentage of fluid, but as we age, the disc begins to dry out. When this happens, eventually the disc will lose height and the two vertebrae are no longer as separated as they once were. This is what is meant by "disc dessication."

The disc is comprised of a tough, outer ring called the annulus, and a softer, gel-like center called the nucleus pulpous. The annulus is like a belted radial tire that wraps around the nucleus and holds it in. Due to injury or just wear and tear, a rip can develop in the annulus. Sometimes when this happens, the center can leak out a bit...or it can break into fragments when badly injured. The annulus itself can bulge, much like a bulge in the side of a water balloon. When the disc bulges out, it can end up pushing into an area that is a passageway for the nerves as they exit the spine. When this happens, there no longer is enough room for the nerves and the bulging tissue, so the nerve or nerves end up getting irritated or squished. Because the cervical nerves carry signals to the upper limbs, this nerve compression can result in pain to the arms and hands, and upper body, depending on which nerve it is. In the cervical area, bulges can also press hard enough that the spinal cord can be indented.

And finally the MRI mentions there is some facet arthropathy at a couple levels. The facets are synovial facet joints that connect to the back of the vertebrae and connect one vertebrae to the adjacent one. They are subject to arthritic changes just like any other joint in the body like the knee or finger or hip....when there are signs of degenerative changes, the surface of the joints start to get roughed up, the ligaments can thicken, and they can become painful. You will see that you have facet arthropathy at many levels in the cervical area of the spine.

To see which cervical levels are affected, you can look at a dermatome chart online and see which cervical nerves innervate which areas of the body. It may help to explain some of your symptoms....

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