Question: Hello! I am a 45yo F, in general good health, just over two years post MVA ( rear end collision - I was the impacted vehicle, while at a complete stop, struck from behind by a vehicle estimated speed 55mph). As a result, I have had L rotator cuff surgery along with cubital tunnel release of L ulnar and later a transposition of L unlar to attempt relief of ongoing nerve pain. At the beginning of physical therapy for surgical recovery 6 weeks post-op, I began to experience ongoing thoracic pain issues, mostly manifesting around L rhomboid area and some right "creeping" sensation right at the bra line. After much insistence on my part, a thoracic MRI was performed and following is the report. My provider told me "not much notable" when reading it. As a student almost completing her BSN, I feel there is a little notable. I am considering a second opinion. I would also like to add at the T1/2 and 5/6 areas are where my areas of most discomfort and "toothache" like pain reside.

I am curious to what a fresh set of eyes sees?

Thank you!


THORACIC SPINE:

TECHNIQUE:
1. T2 sagittal TSE.
2. T2 sagittal FS TSE.
3. T1 sagittal TSE.
4. Sagittal STIR.
5. T2 axial TSE.
6. T1 axial TSE.
7. T2 axial SPACE.

FINDINGS: Thoracic alignment appears maintained.

There is heterogeneity of marrow signal. Area of foci of T1 and T2 hyperintensity within the T5 and T8 vertebral bodies consistent with hemangiomata.

There is focus of T1 and T2 hyperintensity within the anterior superior corner of L2 probably reflecting Modic type 2 end plate change.

There is mild diffuse narrowing of thoracic intervertebral disks. There is diminished intervertebral disk signal present diffusely.

At T5-6 there is tiny disk osteophyte complex to right of midline which appears to come close to but not deform the right anterior aspect of thoracic cord. Neural foramina appear patent.

At T6-7 there is low signal extending posteriorly from right posterolateral aspect of the disk suggesting a small disk osteophyte complex which does impress upon the right anterior aspect of the thoracic cord with slight cord flattening. There is no cord edema. The neural foramina appear patent.

Other thoracic disks appear mildly degenerative but without disk protrusions noted.

No fractures or destructive lesions identified.

Thoracic spinal canal appears normal dimensions. No evidence of thoracic cord edema or mass formation.

IMPRESSION: Mild thoracic spondylosis changes. Small right posterolateral T6-7 disk osteophyte complex which does encroach upon the right anterior aspect of the thoracic cord though without significant cord edema. No left-sided neural foraminal narrowing or disk protrusion identified to account for patient's reported left-sided symptomatology.