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What Does This MRI Report Indicate?
Question: I had an MRI done a few days ago. lumbar. I am experiencing intermittent mild to extreme pain that is exacerbated by lying prone (hence, i do not spend 8 hrs in bed, usually end up in easy lounge chair. been going on at this level for about 8 months. increasing incrementally in episodes and pain threshold. the radiologist could only find end plate edema. my orthopedic specialist has scheduled me for a bone scan. he is interpreting the whitish grey areas as something else. i have prostate cancer (removed july 9, 2014) cancer was 7 to 10 % of the gland. PSA started at 0.00 after surgery, presently at .20 . The pain is ridiculous standing up from sitting for any length of time. must stand still to get steady and take slow steps, pain slowly subsides and walking becomes fairly normal only to be repeated in similar circumstances. i am wondering if i am a victim of "referred pain" which i understand covers the area i am complaining about , lumbar, right hip , pelvic area , upper thighs, also have edema, both legs . i have another issue , also, i.e., cannot tolerate opiates in pain killers, i itch terribly, i thought ultram was the answer, but now that is causing same side effects due to increased dosage. that's about it, thank you
Brief Answer:
Needs further evaluation
Detailed Answer:
Hi,
Thank you for posting the question.
I have gone through your medical history in detail.
The "end plate oedema" that has been mentioned about in the MRI is definitely significant and cannot be neglected.
It can be due to chronic inflammatory diseases like Koch's spine,brucellosis or it may be a early sign of prostate cancer metastasis.
Chances of prostate cancer metastasis is very high as it has been two and a half years since it was operated.Although it was removed surgically,still there are chances of metastasis to distant sites.
I am sure the orthopedist who has advised bone scan has the same thing in his mind.He wants to find out other sites of early metastasis in bones elsewhere in the body.
I suggest you to wait till the bone scan is done.
Meanwhile,get complete blood count and tumor markers checked.
This will give us a clue about the diagnosis.
As far as pain killers are concerned,try taking etodolac,piroxicam or paracetamol which are considered to be safe analgesics without causing much side effects.
Use lumbar support belt,do not lift anything heavy,do not bend forward to avoid aggravating the problem.
I hope the answer was useful.
Do let me know once the reports are ready.
Thank you.
Best regards.
Needs further evaluation
Detailed Answer:
Hi,
Thank you for posting the question.
I have gone through your medical history in detail.
The "end plate oedema" that has been mentioned about in the MRI is definitely significant and cannot be neglected.
It can be due to chronic inflammatory diseases like Koch's spine,brucellosis or it may be a early sign of prostate cancer metastasis.
Chances of prostate cancer metastasis is very high as it has been two and a half years since it was operated.Although it was removed surgically,still there are chances of metastasis to distant sites.
I am sure the orthopedist who has advised bone scan has the same thing in his mind.He wants to find out other sites of early metastasis in bones elsewhere in the body.
I suggest you to wait till the bone scan is done.
Meanwhile,get complete blood count and tumor markers checked.
This will give us a clue about the diagnosis.
As far as pain killers are concerned,try taking etodolac,piroxicam or paracetamol which are considered to be safe analgesics without causing much side effects.
Use lumbar support belt,do not lift anything heavy,do not bend forward to avoid aggravating the problem.
I hope the answer was useful.
Do let me know once the reports are ready.
Thank you.
Best regards.
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Dear Dr. Patil:
Thank you for the informative answer. It was very helpful. As you can imagine, I am experiencing a bit of anxiety over the upcoming bone scan. The best I can hope for is no metastasis of the prostate cancer, but i must know as soon as possible so a treatment regimen can be started.
I notice that you didn't comment on the oncologist's views that "this couldn't possibly be cancer because my PSA levels are far too low. I am not asking you to take sides, however, I would appreciate your opinion concerning the fact that he only uses one marker to determine if the cancer has spread and that is the PSA blood test. In general terms , do you feel that more markers should be checked? Don't worry, i am not going to XXXXXXX him if I do have a metastasis. My wife works as a patient liaison (helping patients get assistance from the drug companies & charitable organizations to help pay for the enormous costs of the latest cancer drugs) at a cancer center in town and this is how I got to know him because he works there as the chief oncologist. And, last, would you be interested in looking at the latest MRI, if so, is there a way to facilitate the upload on this website?
Thank you for the informative answer. It was very helpful. As you can imagine, I am experiencing a bit of anxiety over the upcoming bone scan. The best I can hope for is no metastasis of the prostate cancer, but i must know as soon as possible so a treatment regimen can be started.
I notice that you didn't comment on the oncologist's views that "this couldn't possibly be cancer because my PSA levels are far too low. I am not asking you to take sides, however, I would appreciate your opinion concerning the fact that he only uses one marker to determine if the cancer has spread and that is the PSA blood test. In general terms , do you feel that more markers should be checked? Don't worry, i am not going to XXXXXXX him if I do have a metastasis. My wife works as a patient liaison (helping patients get assistance from the drug companies & charitable organizations to help pay for the enormous costs of the latest cancer drugs) at a cancer center in town and this is how I got to know him because he works there as the chief oncologist. And, last, would you be interested in looking at the latest MRI, if so, is there a way to facilitate the upload on this website?
Brief Answer:
Query answered
Detailed Answer:
Hi,
Welcome back.
PSA levels can be used as gross marker and not as a specific marker.
There are many prostatic cancer patients in whom PSA levels are well within normal range.
It is just 70% sensitive marker.
There are other markers as well like hK2, IGF-1, IGFPBs, TGF-b1, IL-6 etc.
But none of them is specific for metastasis.
Confirmation can only be done by clinico-pathological correlation.
I would surely like to go through your MRI reports / films or any other reports that you may have.
There definitely is a provision of attaching reports with the question on this website.
Please check it out.
Thank you.
Query answered
Detailed Answer:
Hi,
Welcome back.
PSA levels can be used as gross marker and not as a specific marker.
There are many prostatic cancer patients in whom PSA levels are well within normal range.
It is just 70% sensitive marker.
There are other markers as well like hK2, IGF-1, IGFPBs, TGF-b1, IL-6 etc.
But none of them is specific for metastasis.
Confirmation can only be done by clinico-pathological correlation.
I would surely like to go through your MRI reports / films or any other reports that you may have.
There definitely is a provision of attaching reports with the question on this website.
Please check it out.
Thank you.
Above answer was peer-reviewed by :
Dr. Prasad
Good afternoon Dr. Patil:
Yesterday, I sent 2 copies of the radiologists notes concerning my last 2 MRI's of which I noted on one that my orthopedist disagreed with the endplate edema diagnosis.
As I had mentioned to you, I was going to contact XXXXXXX computer experts about loading the MRI CD onto the computer & then uploading the file to you via your website. After working on it for about 1.5 hrs. the expert finally had to give up. He said it is impossible to upload the data & photos from the CD to the hard drive, the way the computer language is written.
Therefore, as you said, i will have the bone scan performed tomorrow (Friday) and I will go forward with whatever steps need to be taken based on results. I thank you again for the very pertinent & clearly described information that you provided. This information will be passed on to my doctors, not to tell them what to do, but just to serve as another professional opinion.
Finally, if i may, I would like to inform you of the results of the scan. I should have the results on Monday considering it will be done on a Friday before the weekend. Of course, if i receive earlier, i will send asap. Otherwise, that's all i have for now.
sincerely
XXXXXXX XXXX
Yesterday, I sent 2 copies of the radiologists notes concerning my last 2 MRI's of which I noted on one that my orthopedist disagreed with the endplate edema diagnosis.
As I had mentioned to you, I was going to contact XXXXXXX computer experts about loading the MRI CD onto the computer & then uploading the file to you via your website. After working on it for about 1.5 hrs. the expert finally had to give up. He said it is impossible to upload the data & photos from the CD to the hard drive, the way the computer language is written.
Therefore, as you said, i will have the bone scan performed tomorrow (Friday) and I will go forward with whatever steps need to be taken based on results. I thank you again for the very pertinent & clearly described information that you provided. This information will be passed on to my doctors, not to tell them what to do, but just to serve as another professional opinion.
Finally, if i may, I would like to inform you of the results of the scan. I should have the results on Monday considering it will be done on a Friday before the weekend. Of course, if i receive earlier, i will send asap. Otherwise, that's all i have for now.
sincerely
XXXXXXX XXXX
Brief Answer:
Will wait for the reports
Detailed Answer:
Hi Mr XXXXXXX XXXX,
Its rather unfortunate that you could not upload MRI reports and i am really sorry for that.
As you said,you can go ahead with the bone scan.
Even if you cannot upload reports directly,you can take a snap of the hard copy of the written reports at home and then try to upload it.
Hope it does not turn out to be a metastasis.
Till then,Wish you all the best.
Kind regards.
Will wait for the reports
Detailed Answer:
Hi Mr XXXXXXX XXXX,
Its rather unfortunate that you could not upload MRI reports and i am really sorry for that.
As you said,you can go ahead with the bone scan.
Even if you cannot upload reports directly,you can take a snap of the hard copy of the written reports at home and then try to upload it.
Hope it does not turn out to be a metastasis.
Till then,Wish you all the best.
Kind regards.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Good Morning Dr. Patil:
Actually, i did upload the reports and I put your name on them, so they should be on a pile somewhere, i hope you can find them, if not, i'll send again, no problem
Actually, i did upload the reports and I put your name on them, so they should be on a pile somewhere, i hope you can find them, if not, i'll send again, no problem
Brief Answer:
Haven't recieved the reports
Detailed Answer:
Hi XXXXXXX
I haven't recieved any reports, niether this question shows any reports attached to it.
I request you to contact the customer care to find out the exact way to upload the reports here.
Thank you.
Haven't recieved the reports
Detailed Answer:
Hi XXXXXXX
I haven't recieved any reports, niether this question shows any reports attached to it.
I request you to contact the customer care to find out the exact way to upload the reports here.
Thank you.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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