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What Does The Following Spine MRI Report Indicate?
Question: Hi. In 2012 I had an MRI done on my spine. Requested by neurologist as I suffer from chronic migraines. After reading the report she informed me I have degenerative arthritis. I later went to a pain specialist "hoping" to find help as none of my neurologists over the last 22 yrs have been of any. She gave me a copy of my MRI and I never read it until yesterday while going through my "important" papers and shredding old info.
I found this at the bottom of my page:
Incidental imaging of the soft tissue neck demonstrates a 2.3 cm dominant nodule within the right thyroid lobe.
2.3 cm nodule of the right thyroid lobe. Benign and malignant lesions of the thyroid cannot be distinguished by imaging, though the presence of a dominant nodule is a risk factor for carcinoma. Clinical correlation is requested. This would be amenable to ultrasound guided sampling, if indicated.
#1. What does this mean?
#2. WHY out of THREE doctors was this NEVER brought to my attention? My neurologist, MD nor the pain management Dr.
#3. Please tell me what to do?
Thanks so much. I'm very upset that no one told me any of this and am concerned about my health.
I found this at the bottom of my page:
Incidental imaging of the soft tissue neck demonstrates a 2.3 cm dominant nodule within the right thyroid lobe.
2.3 cm nodule of the right thyroid lobe. Benign and malignant lesions of the thyroid cannot be distinguished by imaging, though the presence of a dominant nodule is a risk factor for carcinoma. Clinical correlation is requested. This would be amenable to ultrasound guided sampling, if indicated.
#1. What does this mean?
#2. WHY out of THREE doctors was this NEVER brought to my attention? My neurologist, MD nor the pain management Dr.
#3. Please tell me what to do?
Thanks so much. I'm very upset that no one told me any of this and am concerned about my health.
Brief Answer:
Thyroid nodule
Detailed Answer:
I understand you are referring to this incidental finding on a 2012 MRI.
Typically in these circumstances, the next step is to do an Ultrasound of the thyroid/neck because Ultrasound is the best way to assess a thyroid nodule. It can give a good idea regarding characteristics that help distinguish between benign and malignant nodules. However, often ultrasound alone is not enough and other things are necessary to put together a composite picture, such as your history and results of a biopsy (if performed).
1 Thyroid nodules
These are not at all uncommon, particularly as one grows older. They tend to occur more commonly in females than males.
The majority of these (92 to 95%) are benign.
2 I do not know why three doctors did not bring this to your attention
3 What is to be done now?
When I see a person like this with an incidental thyroid nodule, I order an Ultrasound of the thyroid/neck.
I also ask the person a list of questions which give me an idea of this individual has any risk factors for thyroid cancer. Having any of them does not necessarily mean there is cancer. it just gives me an overall broad idea what degree of intervention to plan such as surgical removal right away versus biopsy first.
1 Do you have a family history of thyroid cancer
2 Do you have a past history of thyroid cancer
3 Were you ever exposed to upper body radiation such as that for head/neck area cancers, or exposed to a nuclear disaster?
4 Were you ever given radiation treatment for acne?
5 Do you have any pressure symptoms in the neck such as
Difficulty speaking
Difficulty swallowing
Difficulty breathing
Change in voice
Hoarseness of voice
Neck pain
6 Do you have any bone pains?
7 Flushing?
8 Cough
9 Cough with blood in it?
10 Weight loss?
11 Any high blood pressure problem, especially with it being difficult to control or bouncing around?
12 High calcium in blood ?
----
Furthermore, it is important that an endocrinologist examines your neck and you in general personally to make the right decision on managing this.
As I said, the vast majority are not cancer, but a comprehensive evaluation is required
Thyroid nodule
Detailed Answer:
I understand you are referring to this incidental finding on a 2012 MRI.
Typically in these circumstances, the next step is to do an Ultrasound of the thyroid/neck because Ultrasound is the best way to assess a thyroid nodule. It can give a good idea regarding characteristics that help distinguish between benign and malignant nodules. However, often ultrasound alone is not enough and other things are necessary to put together a composite picture, such as your history and results of a biopsy (if performed).
1 Thyroid nodules
These are not at all uncommon, particularly as one grows older. They tend to occur more commonly in females than males.
The majority of these (92 to 95%) are benign.
2 I do not know why three doctors did not bring this to your attention
3 What is to be done now?
When I see a person like this with an incidental thyroid nodule, I order an Ultrasound of the thyroid/neck.
I also ask the person a list of questions which give me an idea of this individual has any risk factors for thyroid cancer. Having any of them does not necessarily mean there is cancer. it just gives me an overall broad idea what degree of intervention to plan such as surgical removal right away versus biopsy first.
1 Do you have a family history of thyroid cancer
2 Do you have a past history of thyroid cancer
3 Were you ever exposed to upper body radiation such as that for head/neck area cancers, or exposed to a nuclear disaster?
4 Were you ever given radiation treatment for acne?
5 Do you have any pressure symptoms in the neck such as
Difficulty speaking
Difficulty swallowing
Difficulty breathing
Change in voice
Hoarseness of voice
Neck pain
6 Do you have any bone pains?
7 Flushing?
8 Cough
9 Cough with blood in it?
10 Weight loss?
11 Any high blood pressure problem, especially with it being difficult to control or bouncing around?
12 High calcium in blood ?
----
Furthermore, it is important that an endocrinologist examines your neck and you in general personally to make the right decision on managing this.
As I said, the vast majority are not cancer, but a comprehensive evaluation is required
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
No one in family with thyroid cancer. Have had several CT Scans & MRI's due to 22 years of migraines.
Symptoms over last year and a half to 2 yrs are as follows: Shortness of breath, cough (I assume b/c I'm a smoker). Flushing from neck up and feel like I'm on fire ( had partial hysterectomy in 2012, assuming these are hit flashes?). Voice has changed somewhat but once again blamed it on smoking. Had pneumonia last Sept. which led to pleurisy. Sent for xrays. Had 4 fractured ribs (severe pain), was told it was from coughing too hard? Took until May of this year for complete pain to subside. One day my bp is 120/79 the next it may be 187/95. My heart rate is ALWAYS anywhere bt 90-118 resting with no smoking for at least 20 mins.
Have no idea about calcium in blood. Have actually gained weight-again, I "assumed" it was due to partial hysterectomy.
Last 6mos to 1 yr symptoms: Neck pain in front (where nodule is- I thought it was a swollen muscle, it's easily seen and feels hard to the touch), voice is often hoarse, I'm always, always tired for no reason. Just taking a load of clothes out of dryer causes me to flush & perspire. I can no longer enjoy everyday activities outside as the heat is terribly hot and makes me feel worse! I often have difficulty in swallowing medication and/or food and sometimes awaken gasping for air (feel unable to breathe, as if something is caught in my throat).
I'm not sure how I can get in to see an endocrinologist? And I feel as if I've certainly been mistreated. I could not fathom having a patient who may have serious issues and not telling them:-/
Thank you for your time, patience and kindness. I feel very lost...
Symptoms over last year and a half to 2 yrs are as follows: Shortness of breath, cough (I assume b/c I'm a smoker). Flushing from neck up and feel like I'm on fire ( had partial hysterectomy in 2012, assuming these are hit flashes?). Voice has changed somewhat but once again blamed it on smoking. Had pneumonia last Sept. which led to pleurisy. Sent for xrays. Had 4 fractured ribs (severe pain), was told it was from coughing too hard? Took until May of this year for complete pain to subside. One day my bp is 120/79 the next it may be 187/95. My heart rate is ALWAYS anywhere bt 90-118 resting with no smoking for at least 20 mins.
Have no idea about calcium in blood. Have actually gained weight-again, I "assumed" it was due to partial hysterectomy.
Last 6mos to 1 yr symptoms: Neck pain in front (where nodule is- I thought it was a swollen muscle, it's easily seen and feels hard to the touch), voice is often hoarse, I'm always, always tired for no reason. Just taking a load of clothes out of dryer causes me to flush & perspire. I can no longer enjoy everyday activities outside as the heat is terribly hot and makes me feel worse! I often have difficulty in swallowing medication and/or food and sometimes awaken gasping for air (feel unable to breathe, as if something is caught in my throat).
I'm not sure how I can get in to see an endocrinologist? And I feel as if I've certainly been mistreated. I could not fathom having a patient who may have serious issues and not telling them:-/
Thank you for your time, patience and kindness. I feel very lost...
Brief Answer:
Follow up
Detailed Answer:
I have noted your comments.
You must seek prompt care with an endocrinologist as well as an ENT surgeon and a pulmonologist. These symptoms of yours cannot be ignored
Follow up
Detailed Answer:
I have noted your comments.
You must seek prompt care with an endocrinologist as well as an ENT surgeon and a pulmonologist. These symptoms of yours cannot be ignored
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your answer. Could you please tell me how to go about getting in to see these doctors? Do I ask my MD? Do I need to PUSH getting in with them? How exactly, would I ask my MD to send me to these places? I have appointment with my MD Tuesday, and I'm pretty certain they will want me to do another MRI. Can you tell me if you have ANY idea of what is going on?
Thank you...
Thank you...
Brief Answer:
Second follow up
Detailed Answer:
Typically, you need to see your family doctor or primary care provider at the soonest possible opportunity. The primary doctor will refer you to relevant specialists.
It is hard to give you a specific diagnosis as you have multiple complaints.
I hope you find the care you need, soon
Second follow up
Detailed Answer:
Typically, you need to see your family doctor or primary care provider at the soonest possible opportunity. The primary doctor will refer you to relevant specialists.
It is hard to give you a specific diagnosis as you have multiple complaints.
I hope you find the care you need, soon
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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