What Does The Following MRI Result Suggest?

Posted on Thu, 16 Jul 2015

Question: 25 year old male. I have been seeing a phsyiatrist for lower back issues. During a routine MRI of the sacroiliac joints, the radiologist made an incidental finding. The MRI results are:

Indication: Bilateral sacroiliac joint pain and conjunctivitis and epididymitis. Query seronegative spondyloarthropathy.

Findings:

There is linear edema involving both sides of the inferior aspect of the sacroiliac joints bilaterally. No erosive changes or fatty marrow replacement.

On one of the localizer sequences, incidental note is made of abnormala signal involving the entirety of one of the thoracic vertebral bodies (series 1, image 3)

Opinion:

1) Linear edema along the inferior aspect of the sacroiliac joints bilaterally iwth no erosions. This is relatively nonspecific, but may be seen in the setting of inflammatory arthritis

2) Incidental, incompletely assessed, abnormal marrow signal in one of the thoracic vertebral bodies identified on a localizer sequence. An MRI of the entire spine may be considered to assess for other findings of spondyloathropathy, at which point this thoracic finding can be further assessed. Irrespective of whether an inflammatory spine MRI study is performed, the thoracic spine abnormality should be assessed with dedicated MR imaging.

My Question:

1) Do these results support spondylitis?
2) What can cause the abnormality in the thoracic spine?
3) to be blunt.... do they think i have cancer, or can it be related to the spondylitis?

Answered by Dr. Indu Kumar (8 hours later)

Brief Answer:
It may be part of spondyloarthropathy that includes spondylitis.

Detailed Answer:
Hello

Your report suggests edema in bilateral sacro-iliac joints(inferior region).It may be non specific finding.However,since you have back ache it may also indicate spondyloarthropathy. But it is important to see other joints - X-rays both hands, whole spine, etc.
Spondylitis term is restricted to vertebral involvement only.
This also need clinical correlation.

Marrow signal abnormality in one vertebra may be seen in some persons. It may due to benign reasons. It may be due to incomplete marrow conversion. You may need whole spine MRI and detail study of involved thoracic vertebra.

Findings generally doesn't indicate cancer. It may be part of spondyloarthropathy that includes spondylitis.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Indu Kumar (40 hours later)

Thank you. could it possibly be a Vertebral body hemangioma? I have a wealth of lumbar issues....

L3-L4 mild broad based posterior disc bulging
L4-L5 mild broad based posterior disc bulging. Grade 1 retrolisthesis L4-L5
L5-S1 moderate broad based posterior disc bulging. grade 1 anterolesthisis related to bilateral L5 pars defect. encroachment on both L5 nerve root foramen as a result of degenerative changes.

would this have anything to do with my upper back issues as well? what would be causing all these back issues at the age of 25? never been in any accidents, and other than being a smoker, I am relatively healthy.

thanks again

Answered by Dr. Indu Kumar (9 hours later)

Brief Answer:
Disc bulge and nerve root compression may be related to your symptoms.

Detailed Answer:
Hello

Hemangioma has typical appearance in MRI imaging and it can't be missed.
Your MRI findings suggests degenerative changes in L/S spine.These are generally age related changes.Findings are early in your case.
Disc bulge and nerve root compression may be related to your symptoms.

I suggest for physiotherapy according to your age.It will strengthen back muscles and prevent further changes.

Spine dynamics is a complex mechanism and it depend upon many things.Degenerative changes may be seen early.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar