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What Are The Spots Noticed In The Center Of The Disc Of A CT Scan?
Question: I have been having pain in my bones for years and every doctor I go to gives me a different answer...so frustrated!! My last scan I am showing a white and black spot in one of my vertebrae. I have a picture that I can send of it...I would like another opinion before I go to a new ortho!
Thank you
Thank you
Brief Answer:
I would certainly appreciate that sir/ma'am
Detailed Answer:
Hello sir/ma'am and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. I would certainly appreciate the image you have and would like to view it, if you do not mind. You can attach it to our discussion or send it to:
YYYY@YYYY
and in the subject bar, please mention "ATTN: Dr. Shoaib Khan"
I need to look at the film to look for signs of destruction, etc. I look forward to your response in order to help you further. If you do not mind, please also mention your age and sex (if you are female, then I would also like to know if you have attained/reached menopause), it would certainly help.
Best wishes.
I would certainly appreciate that sir/ma'am
Detailed Answer:
Hello sir/ma'am and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. I would certainly appreciate the image you have and would like to view it, if you do not mind. You can attach it to our discussion or send it to:
YYYY@YYYY
and in the subject bar, please mention "ATTN: Dr. Shoaib Khan"
I need to look at the film to look for signs of destruction, etc. I look forward to your response in order to help you further. If you do not mind, please also mention your age and sex (if you are female, then I would also like to know if you have attained/reached menopause), it would certainly help.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am not sure if you received my response my phone acting up, so I'll resend. I will email the attachment I have more but from a ct scan. Pics being sent are from mri. I am 38 year old female. Put into medical menopause over 5 years ago. I have been experiencing lots of pain in sacrum joint where it feels like it's gonna snap off. Lately I have had low wbc and body not absorbing potassium. Been experiencing severe swelling in every joint in entire body and electrical jolting sensations in my kidney area and in my head. I have had a dexa scan and is negative as well as RA, lupus, graves, etc.
Brief Answer:
Cause may not be all that serious, need radiologist report
Detailed Answer:
Hello once again ma'am.
Sorry for the delay, I had to wait for the image to be attached to our discussion so I could view it. It appears as though the spot is in the region of the vertebral body, and if at all you have the printed report from a radiologist as well, please do write to me with the report or attach this as well to our conversation.
The first thing I would like to ask is about your vitamin D and calcium levels, whether they were checked and if so please do write back with their values. Are you on any vitamin D and/or calcium supplements?
+Any trauma to the lumbar region?
+Any surgeries to the spine previously?
+Any MRI of the same region previously taken?
+Exact location of your pain?
+Which vertebral bodies are affected as per the MRI report?
The black spot has a clear border and so is most probably any of the following conditions:
+Neurofibromatosis
+Cyst
and a few other possibilities.
The report from the radiologist would be most beneficial, please do write to me about the same. I look forward to hearing from you, please do write back to me with your kind response.
Best wishes.
Cause may not be all that serious, need radiologist report
Detailed Answer:
Hello once again ma'am.
Sorry for the delay, I had to wait for the image to be attached to our discussion so I could view it. It appears as though the spot is in the region of the vertebral body, and if at all you have the printed report from a radiologist as well, please do write to me with the report or attach this as well to our conversation.
The first thing I would like to ask is about your vitamin D and calcium levels, whether they were checked and if so please do write back with their values. Are you on any vitamin D and/or calcium supplements?
+Any trauma to the lumbar region?
+Any surgeries to the spine previously?
+Any MRI of the same region previously taken?
+Exact location of your pain?
+Which vertebral bodies are affected as per the MRI report?
The black spot has a clear border and so is most probably any of the following conditions:
+Neurofibromatosis
+Cyst
and a few other possibilities.
The report from the radiologist would be most beneficial, please do write to me about the same. I look forward to hearing from you, please do write back to me with your kind response.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The radiologist reports are from the ER, and they do not go into thorough details on anything. On one from 2 years ago is states that there is a high density seen. But not sure if it is the same region.
The black spot does not appear to have a border around it when I look at it on the big screen. And what is the white spot? I have a few white spots on other parts of my spine also. My primary seems to think they are lesions, I have never seen an orthopedic for this issue yet due to my insurance. I do have an appointment next week though.
My calcium & vitamin D levels are normal & have always been normal. No supplements are taken for anything.
+I have had no trauma to the spine
+No surgeries to the spine
+I have MRI's & CT scans taken throughout the past 3 years - The first MRI only shows the white spot very small (2012), In 2013 the black spot appeared, not as big & the white spot got bigger, in 2014 (which is the picture I sent) they are both bigger in size. On the vertabrae below this one on a different view you can see both spots and a darker larger looking spot (not defined looking like the one sent) I thought it may just be a shadow...but not sure.
+Funny enough the most severe pain I have is in my tailbone, It severely disturbs my daily life, when I try to sleep at night I have extreme pressure like it is gonna snap off no matter which way I lay. Above that I also have severe pain in my whole lumbar, and just recently I have been experiencing severe pain in between my shoulder blades. SO it is hard to pinpoint an exact area of pain...it is pretty much the whole spine.
+I for sure have some bulging disks in my L-5/S-1 & L-4/L-5 I have reports from XXXXXXX telling me that I have spinal stenosis, neuroforaminal stenosis, generalized disc bulge with ligamentum flavum hypertrophy, and central disc protusion, lumbar spondylosis, all in the lower lumbar area listed above. Know when I got the same scan in my hometown - Cape Coral, it only shows a small disc bludge, I get different opinions from all the different hospitals I have been too...kinda frustrating!!!
I am a bit nervous because my father passed at a young age and when they did they found tumors in his entire spine....little nerve wrecking :-(
I also have had issues with having kidney stones on one test, then not on another test, lumps popping up under skin, bad brusies just showing up from nowhere, just to name a few other issues. I have had some CBC tests come back with low WBC, high Neurophils, low potassium, & low anion gap more than once over the years...am always told that I have a flu...but never any flu symptoms.
This all started in my hips almost 4 years ago, I was told I had bone marrow edema and they never found out why, at that time my spine was fine, no pain or problems, as the years have past my hips are extremely bad and now my spine too.
I hope I shared enough information, I can keep going but I want you to take all this in first.
Thank You,
XXXXXX
The black spot does not appear to have a border around it when I look at it on the big screen. And what is the white spot? I have a few white spots on other parts of my spine also. My primary seems to think they are lesions, I have never seen an orthopedic for this issue yet due to my insurance. I do have an appointment next week though.
My calcium & vitamin D levels are normal & have always been normal. No supplements are taken for anything.
+I have had no trauma to the spine
+No surgeries to the spine
+I have MRI's & CT scans taken throughout the past 3 years - The first MRI only shows the white spot very small (2012), In 2013 the black spot appeared, not as big & the white spot got bigger, in 2014 (which is the picture I sent) they are both bigger in size. On the vertabrae below this one on a different view you can see both spots and a darker larger looking spot (not defined looking like the one sent) I thought it may just be a shadow...but not sure.
+Funny enough the most severe pain I have is in my tailbone, It severely disturbs my daily life, when I try to sleep at night I have extreme pressure like it is gonna snap off no matter which way I lay. Above that I also have severe pain in my whole lumbar, and just recently I have been experiencing severe pain in between my shoulder blades. SO it is hard to pinpoint an exact area of pain...it is pretty much the whole spine.
+I for sure have some bulging disks in my L-5/S-1 & L-4/L-5 I have reports from XXXXXXX telling me that I have spinal stenosis, neuroforaminal stenosis, generalized disc bulge with ligamentum flavum hypertrophy, and central disc protusion, lumbar spondylosis, all in the lower lumbar area listed above. Know when I got the same scan in my hometown - Cape Coral, it only shows a small disc bludge, I get different opinions from all the different hospitals I have been too...kinda frustrating!!!
I am a bit nervous because my father passed at a young age and when they did they found tumors in his entire spine....little nerve wrecking :-(
I also have had issues with having kidney stones on one test, then not on another test, lumps popping up under skin, bad brusies just showing up from nowhere, just to name a few other issues. I have had some CBC tests come back with low WBC, high Neurophils, low potassium, & low anion gap more than once over the years...am always told that I have a flu...but never any flu symptoms.
This all started in my hips almost 4 years ago, I was told I had bone marrow edema and they never found out why, at that time my spine was fine, no pain or problems, as the years have past my hips are extremely bad and now my spine too.
I hope I shared enough information, I can keep going but I want you to take all this in first.
Thank You,
XXXXXX
Brief Answer:
A few points to be discussed ma'am
Detailed Answer:
Hello once again ma'am.
I have gone through all the details of your query and would like to explain a few things to you for your better understanding.
1. The spots noticed are in the centre of the disk called the nuclei of the vertebral body. This change can be related to ageing or menopause in women, and occurs because the proteins in the centre of the disk lose their water content making them hard. Due to the change in their consistency, the delivery of blood to the centre becomes more and more difficult, and gradually even shuts down. This results in the change in colour noticed on film, which is the region of high density. The conclusion given is 'degenerative disk disease'.
I do certainly concur with the radiologist on the spots being lesions, but commenting on the cause will most certainly be difficult. This could be signs of degenerative disk disease (findings supporting this even more are reports of lumbar spondylosis, neuroforaminal stenosis, etc.). With the generalised disc bulge finding, the diagnosis would then become 'multi-level degenerative disk disease'. But I would also like to add that this is one of the possibilities and not a confirmation.
2. As you do have a positive family history of spine related abnormalities, it would be wise to be more vigilant and reach the core to this problem. In most cases, with a bulging disc, surgery is advised to relieve the pressure (e.g. disc laminectomy). Please speak to your doctor about the same.
3. Findings like spinal stenosis, neuroforaminal stenosis, generalised disc bulge with ligamentum flavour hypertrophy, central disc protrusion, lumbar spondylosis, etc; all place you in the category of 'surgical candidate'. So surgery would certainly help relieve your symptoms to quite an extent, and during surgery your doctor can get a closer look at the affected region.
4. your condition seems to be getting worse with passing time, which means this is a progressive and degenerative condition, action needs to be taken soon, so please do weigh your options and opt for a surgical solution at the earliest ma'am.
I hope I have explained things in a manner best understood by you. Please feel free to write back to me for any further clarifications, I would be more than happy to help you.
Best wishes.
A few points to be discussed ma'am
Detailed Answer:
Hello once again ma'am.
I have gone through all the details of your query and would like to explain a few things to you for your better understanding.
1. The spots noticed are in the centre of the disk called the nuclei of the vertebral body. This change can be related to ageing or menopause in women, and occurs because the proteins in the centre of the disk lose their water content making them hard. Due to the change in their consistency, the delivery of blood to the centre becomes more and more difficult, and gradually even shuts down. This results in the change in colour noticed on film, which is the region of high density. The conclusion given is 'degenerative disk disease'.
I do certainly concur with the radiologist on the spots being lesions, but commenting on the cause will most certainly be difficult. This could be signs of degenerative disk disease (findings supporting this even more are reports of lumbar spondylosis, neuroforaminal stenosis, etc.). With the generalised disc bulge finding, the diagnosis would then become 'multi-level degenerative disk disease'. But I would also like to add that this is one of the possibilities and not a confirmation.
2. As you do have a positive family history of spine related abnormalities, it would be wise to be more vigilant and reach the core to this problem. In most cases, with a bulging disc, surgery is advised to relieve the pressure (e.g. disc laminectomy). Please speak to your doctor about the same.
3. Findings like spinal stenosis, neuroforaminal stenosis, generalised disc bulge with ligamentum flavour hypertrophy, central disc protrusion, lumbar spondylosis, etc; all place you in the category of 'surgical candidate'. So surgery would certainly help relieve your symptoms to quite an extent, and during surgery your doctor can get a closer look at the affected region.
4. your condition seems to be getting worse with passing time, which means this is a progressive and degenerative condition, action needs to be taken soon, so please do weigh your options and opt for a surgical solution at the earliest ma'am.
I hope I have explained things in a manner best understood by you. Please feel free to write back to me for any further clarifications, I would be more than happy to help you.
Best wishes.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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