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What Does Fullness Of The Left Renal Pelvis Mean?

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Posted on Tue, 9 Sep 2014
Question: What is fullness of the left renal pelvis mean. Also what does mild ventral cord impingement related to disc protrusion at the C6-C7 level. Then there is small multilevel thoracic disc protrusions without significant cord impingement thoracic protrusions without significant cord impingement or central stenosis. I just don't understand.
doctor
Answered by Dr. Vinay Bhardwaj (5 hours later)
Brief Answer:
Lets break this down and go line by line

Detailed Answer:
Hi there, thanks for coming to HealthCareMagic. I understand how difficult the jargon from a radiology report can be. Let me see if I can break down what you've put in here line by line and give you some basic information so you know whats going on.

1) "Fullness of the left renal pelvis mean"

So, our kidney, as you know, is an organ that filters the toxins out of our blood and then throws all that nasty stuff into a waste product called urine. Deep in the core of the kidney, there is a space that allows for the collection of urine before it gets piped into a long tube called the ureter and heads for our bladder and then the great outdoors. That space is called the "Renal Pelvis"

The thing you have to realize to understand this cryptic line, is that this is an ongoing process... the kidney is constantly filtering and urine is constantly being pumped into the pelvis before it drains through the ureter to the bladder.

Now, if there is something that is slowing down the flow of urine, say in the ureter or the bladder, then the Renal Pelvis is going to get backed up with urine and stretch a bit. When a scan is done, the radiologist might pick up on that and give the comment they gave.

For the most part, there's nothing to worry about here, a scan would show some mild renal pelvic fullness if a person has not gone to the bathroom in a few hours.
If you have been having any urinary symptoms.. burning, infections etc. Then the cause for this fullness has to be investigated further. If not, then I don't think it worth thinking too much about. You always have to be careful with Radiologists. They comment on what they see.. a picture.. and not the patient. So every tiny variation from the norm is notable for them, even though all of us, though we may be healthy as a horse, will have such tiny variations. You always have to make sure your doctor is using the results of the scan to correlate them with your symptoms.

2) Now, next line: "Mild ventral cord impingement related to disc protrusion at the C6-C7 level"

We move on up from the bladder and enter the spinal column. The C6-C7 level of the spinal column is roughly the area that your neck meets your chest and maybe a bit below.

Now the spinal cord is a beautifully constructed system that is highly flexible yet provides incredible protection to the fragile spinal cord, our brains connection to the rest of the body.

To provide flexibility and reduce friction between the bones in the spinal column, we have soft pads of fibre and gel called intervertebral discs placed between the vertebrae (the bones of the spinal column) . These discs are amazing and provide the perfect balance between flexibility and protection. But they do undergo quite a bit of wear and tear as we age. they have a limited ability to repair themselves. So as we age, they tend to pancake out and "protrude" into the spaces near the spinal cord.

That protrusion is what the radiologist is talking about here. Now, is it significant? Should we worry about it? I dunno. It depends on your symptoms. The C6-C7 level of the cord carries nerves that go to parts of the arms, hands and chest wall. If you have been having any pain or weakness in the area. Then that protrusion may be the cause of the symptoms. If you don't have any symptoms.. then it needs to be ignored. about 60% of the population walks around with such protrusions and they never know about it, they lead full and active lives in spite of the degenerative disease the discs are undergoing.

3) Onward we go: "Small multilevel thoracic disc protrusions without significant cord impingement thoracic protrusions without significant cord impingement or central stenosis."

Here, the radiologist is reporting the same process I mentioned on the earlier line. A few of the discs are degenerating / pancaking out. But here the radiologist is saying that they can't see that the discs are affecting the spinal cord. This is a VERY common finding in lots of people as we age, and usually never amounts to anything. Stenosis is fancy pants doctor-speak for narrowing of the spinal canal (the thin canal inside the spinal column where the spinal cord lives).

This third line, again, is nothing to worry about. If you have been having any weakness or rib cage pain, or severe back pain in the middle back.. Then we need to look deeper, but this line doesn't trigger any major red flags with me.

So, in my opinion, the most significant finding in what you have mentioned is the C6-C7 disc protrusion. Have you had any weakness of your arms, shoulders or chest? Any pain? That would be a significant correlation that needs to be looked into.

So there you go. I did my best to translate the lines that you've given me. Any extra information you can give me about your situation and why you got the scans will allow me to give you more context and be more useful to you overall.

I hope this helps. I look forward to your thoughts.

Vinay
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vinay Bhardwaj (2 hours later)
I want to Thank You for answering my question. The reason for the MRI was because I have been having numbness in my left arm. I also have been losing strength in both of my hands. I have a spot in the middle of my back that has no feeling at all. It is where the shoulder blades some what meet. You could touch it and I don't feel you touching that spot. I know that you are touching it but I just can't feel it. I also have lower back problems. My lower back will hurt if I stand for about 5 minutes. If I stand longer than 5 minutes I will be bent over in pain. I can only walk for about 5 to 10 minutes. I can't walk up and down stairs. I also can't lift or carry anything over 5lbs. If I do my back will hurt for days. I have no feeling in my outer side of my left thigh. I also have pain in both of my hips. The numbness in my left arm, losing strength in both hands, and the no feeling in the middle of my back has been going on for 2 months. The problem with my lower back has been going on for 4 to 5 years. The numbness in my thigh has been going on for 2 years. My doctor has put me on mediation for the pain and for the numbness in my thigh. The mediation is Norco 10-325 mg 4x's a day and Gabapentin 400 mg 3x's a day. But it does not always work any more and I really don't like the fact that I have been of these pills for years. I really need someone who can help me out. My doctor does not believe in surgery and does not want to talk about surgery but I really don't know if surgery would work for me. I know that I have no real life. If you could give any info it would help out a lot. Thank you very much.
doctor
Answered by Dr. Vinay Bhardwaj (27 hours later)
Brief Answer:
Symptoms match the Imaging

Detailed Answer:
Hey there, Thanks for getting back to me.

I'm really sorry to hear about the pain and weakness you've had to bear. In my opinion, the symptoms that you are suffering from do seem to stem from the C6-7 disc protrusion that you mentioned at the beginning.

I would be more confident if i could see the images for myself. And examine you for myself for that matter. But from what you told me, it seems like dealing with that disc would give you a chance at controlling the weakness and pain you have been suffering from.

"Dealing" with that disc would involve surgery. Now, the thing is, surgery is no minor issue. Surgical correction of a disc is a few hours under anasthesia, a big strain on the body, weeks and weeks of recovery and MONTHS of Physical Therapy after that. You're doctor is right to be careful when it comes to recommending surgery.

In this particular case though. I would suggest that you bring up that fact that you're pretty much maxed out on medications to control this and you are only 42. The disease would only progress.

Talk to your doc, see what they say. I would also recommend you get a second opinion from a spine surgeon in your area. Someone who an put all the pieces together and examine you directly. They may recommend further testing called an ENMG. A test where they try and directly test the C6-C7 spinal nerves and see if they are getting compressed.

I'm always here to help and guide when you want it. Will be happy to explain anything I can and help you formulate a plan of action.

Let me know what you are thinking,

Vin
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vinay Bhardwaj

Neurologist, Surgical

Practicing since :2006

Answered : 544 Questions

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What Does Fullness Of The Left Renal Pelvis Mean?

Brief Answer: Lets break this down and go line by line Detailed Answer: Hi there, thanks for coming to HealthCareMagic. I understand how difficult the jargon from a radiology report can be. Let me see if I can break down what you've put in here line by line and give you some basic information so you know whats going on. 1) "Fullness of the left renal pelvis mean" So, our kidney, as you know, is an organ that filters the toxins out of our blood and then throws all that nasty stuff into a waste product called urine. Deep in the core of the kidney, there is a space that allows for the collection of urine before it gets piped into a long tube called the ureter and heads for our bladder and then the great outdoors. That space is called the "Renal Pelvis" The thing you have to realize to understand this cryptic line, is that this is an ongoing process... the kidney is constantly filtering and urine is constantly being pumped into the pelvis before it drains through the ureter to the bladder. Now, if there is something that is slowing down the flow of urine, say in the ureter or the bladder, then the Renal Pelvis is going to get backed up with urine and stretch a bit. When a scan is done, the radiologist might pick up on that and give the comment they gave. For the most part, there's nothing to worry about here, a scan would show some mild renal pelvic fullness if a person has not gone to the bathroom in a few hours. If you have been having any urinary symptoms.. burning, infections etc. Then the cause for this fullness has to be investigated further. If not, then I don't think it worth thinking too much about. You always have to be careful with Radiologists. They comment on what they see.. a picture.. and not the patient. So every tiny variation from the norm is notable for them, even though all of us, though we may be healthy as a horse, will have such tiny variations. You always have to make sure your doctor is using the results of the scan to correlate them with your symptoms. 2) Now, next line: "Mild ventral cord impingement related to disc protrusion at the C6-C7 level" We move on up from the bladder and enter the spinal column. The C6-C7 level of the spinal column is roughly the area that your neck meets your chest and maybe a bit below. Now the spinal cord is a beautifully constructed system that is highly flexible yet provides incredible protection to the fragile spinal cord, our brains connection to the rest of the body. To provide flexibility and reduce friction between the bones in the spinal column, we have soft pads of fibre and gel called intervertebral discs placed between the vertebrae (the bones of the spinal column) . These discs are amazing and provide the perfect balance between flexibility and protection. But they do undergo quite a bit of wear and tear as we age. they have a limited ability to repair themselves. So as we age, they tend to pancake out and "protrude" into the spaces near the spinal cord. That protrusion is what the radiologist is talking about here. Now, is it significant? Should we worry about it? I dunno. It depends on your symptoms. The C6-C7 level of the cord carries nerves that go to parts of the arms, hands and chest wall. If you have been having any pain or weakness in the area. Then that protrusion may be the cause of the symptoms. If you don't have any symptoms.. then it needs to be ignored. about 60% of the population walks around with such protrusions and they never know about it, they lead full and active lives in spite of the degenerative disease the discs are undergoing. 3) Onward we go: "Small multilevel thoracic disc protrusions without significant cord impingement thoracic protrusions without significant cord impingement or central stenosis." Here, the radiologist is reporting the same process I mentioned on the earlier line. A few of the discs are degenerating / pancaking out. But here the radiologist is saying that they can't see that the discs are affecting the spinal cord. This is a VERY common finding in lots of people as we age, and usually never amounts to anything. Stenosis is fancy pants doctor-speak for narrowing of the spinal canal (the thin canal inside the spinal column where the spinal cord lives). This third line, again, is nothing to worry about. If you have been having any weakness or rib cage pain, or severe back pain in the middle back.. Then we need to look deeper, but this line doesn't trigger any major red flags with me. So, in my opinion, the most significant finding in what you have mentioned is the C6-C7 disc protrusion. Have you had any weakness of your arms, shoulders or chest? Any pain? That would be a significant correlation that needs to be looked into. So there you go. I did my best to translate the lines that you've given me. Any extra information you can give me about your situation and why you got the scans will allow me to give you more context and be more useful to you overall. I hope this helps. I look forward to your thoughts. Vinay