Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Does This X-ray Report Indicate?
Question: As per related question, a read of X-ray results could help understand if and how C4-C5-C6-C7 problems are related to an abscess behind right ear, blood emerging close by *after* antibiotics, and a range of C6-C7 nerve effects and rash and blisters happening over the last few weeks. Very different, but so close by.
An MRI and X-ray were taken in April after a very bad abscess behind right ear, had likely been making me sick for a couple months, unnoticed due to location.
An MRI and X-rays were taken four months later in August, and the X-ray identified for the first time a C7 fracture without union. A 28 year old weight-lifting accident had fractured C2, but completely healed. However, pain ever since at the base of the neck is only now explained by this discovery at C7.
Could problems in this area be the cause, not effect, of my problems? Some additional foraminal narrowing was reported to occur even within this four months. And the pain in the C7 areas has returned to levels before discovery of the abscess. Once abscess was cured by antibiotics, all C7 pain dissappeared for the first time in 28 years for about six weeks. Since the blood came out on 21 May close by the abscess, and especially since start of August, the neck pain has come back strongly.
And yet, other than CRP 3 and 5, and Sed 12 and 10, there is no other bacteria or virus tracked down yet.
Instead of being the victim of some other process, could some kind of narrowing or problem in these vertebrae be a cause, for the flow void. inflammation, blisters, and/or raised area on forehead?
The report in French and an English translation will be uploaded in reports. The full X-ray with viewing application available if desired - just ask. Your detective instincts greatly appreciated.
An MRI and X-ray were taken in April after a very bad abscess behind right ear, had likely been making me sick for a couple months, unnoticed due to location.
An MRI and X-rays were taken four months later in August, and the X-ray identified for the first time a C7 fracture without union. A 28 year old weight-lifting accident had fractured C2, but completely healed. However, pain ever since at the base of the neck is only now explained by this discovery at C7.
Could problems in this area be the cause, not effect, of my problems? Some additional foraminal narrowing was reported to occur even within this four months. And the pain in the C7 areas has returned to levels before discovery of the abscess. Once abscess was cured by antibiotics, all C7 pain dissappeared for the first time in 28 years for about six weeks. Since the blood came out on 21 May close by the abscess, and especially since start of August, the neck pain has come back strongly.
And yet, other than CRP 3 and 5, and Sed 12 and 10, there is no other bacteria or virus tracked down yet.
Instead of being the victim of some other process, could some kind of narrowing or problem in these vertebrae be a cause, for the flow void. inflammation, blisters, and/or raised area on forehead?
The report in French and an English translation will be uploaded in reports. The full X-ray with viewing application available if desired - just ask. Your detective instincts greatly appreciated.
Brief Answer:
Cervical infection is possible.
Detailed Answer:
Hello again XXXXXXX
I have read carefully your post about neck problems and its relations with the abscess.
I examinated the x-rays report too.
Regarding to x-rays report, there is fracture of spinous process of C7, or in other words, fracture of one of enlogations of C7, not the body of vertebra.
However, I need to see the x-rays myself.
Since there was improvement after antibiotics use, and there is nonunion of fracture, an infection at this area is possible too.
Dissemination of infection through blood is well known, so, there could be a relationship between the abscess and cervical spinal infection.
Please, upload x-rays picture.
Best regards.
Cervical infection is possible.
Detailed Answer:
Hello again XXXXXXX
I have read carefully your post about neck problems and its relations with the abscess.
I examinated the x-rays report too.
Regarding to x-rays report, there is fracture of spinous process of C7, or in other words, fracture of one of enlogations of C7, not the body of vertebra.
However, I need to see the x-rays myself.
Since there was improvement after antibiotics use, and there is nonunion of fracture, an infection at this area is possible too.
Dissemination of infection through blood is well known, so, there could be a relationship between the abscess and cervical spinal infection.
Please, upload x-rays picture.
Best regards.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks, finally got it up there. It is 194 MB, but everything is there.
williamstewart.com/xray/xraysaug.zip
In case the pattern suggests anything, the severity of symptoms from my internal point of view would be this:
1. Increasing stiffness in back and right of base of neck, pain 3-5 on a steady basis
2. All the right side head problems, freezing and pain, centered inside my right cheekbone and bottom of eye, at worse ice cold in the bottom half of right eye. Not just tingling, more like dental freezing, is common all day in my upper right jaw, with twinges going up through to the top of my nose between my eyes. It feels a bit congested, like a small drip, but never enough I need to blow my nose. All problems on the right are also on the left, but only about a third as bad.
3. When I lie on the right side of my head, or on back of head, the smell of glass cleaner gets strong, I feel dizzy, and cannot continue. I only sleep on my left, and positioning my neck so the pain is low enough is increasingly difficult.
4. Basic inability to work, have to lie down, unless I take ibuprofen.
5. All the skin problems, wedge on head, blisters suddenly popping out, a sudden 2x2 cm blue patch on my foot fading to red through the day.
6. For whatever it's worth, the veins on my right fore-arm are much larger than on my right, last couple weeks, like the pressure in that arm is higher.
Thanks so much,
XXXX
In case you find it useful to compare to the previous X-rays, from May 5, they are here:
http://williamstewart.com/xray/2015.05.05_1514%20(D).zip
williamstewart.com/xray/xraysaug.zip
In case the pattern suggests anything, the severity of symptoms from my internal point of view would be this:
1. Increasing stiffness in back and right of base of neck, pain 3-5 on a steady basis
2. All the right side head problems, freezing and pain, centered inside my right cheekbone and bottom of eye, at worse ice cold in the bottom half of right eye. Not just tingling, more like dental freezing, is common all day in my upper right jaw, with twinges going up through to the top of my nose between my eyes. It feels a bit congested, like a small drip, but never enough I need to blow my nose. All problems on the right are also on the left, but only about a third as bad.
3. When I lie on the right side of my head, or on back of head, the smell of glass cleaner gets strong, I feel dizzy, and cannot continue. I only sleep on my left, and positioning my neck so the pain is low enough is increasingly difficult.
4. Basic inability to work, have to lie down, unless I take ibuprofen.
5. All the skin problems, wedge on head, blisters suddenly popping out, a sudden 2x2 cm blue patch on my foot fading to red through the day.
6. For whatever it's worth, the veins on my right fore-arm are much larger than on my right, last couple weeks, like the pressure in that arm is higher.
Thanks so much,
XXXX
In case you find it useful to compare to the previous X-rays, from May 5, they are here:
http://williamstewart.com/xray/2015.05.05_1514%20(D).zip
Brief Answer:
Facial symptoms not related directly to cervical condition.
Detailed Answer:
Hi again XXXXXXX
I have examined both x-ray films.
There is a fracture of back enlogation (spinous process) of C7 that justifies the symptoms related to stiffness and pain on neck and base of the head (skull).
This pain is most probably caused by fatigued and spasms of neck muscles trying to keep fracture unmovable ( a compensatory mechanism ).
I don't see any fluid collection into the neck or cervical column that may raise the suspect of infection (spondylodiscitis), but since there was improvement after antibiotics use, this possibility cannot be excluded totally neither.
Discs spaces between vertebrae C5-C6-C7 seems to be reduced and this justifies arm pain (probably pinched nerve).
There are degenative changes of thoracolumbar column (small bone spurs) supporting spondyloarthritis as a diagnosis.
Facial pain and sensations seem no to be related to cervical condition.
Probably there was sinusitis that cleared up after abscess treatment with antibiotics.
However, there is still hyperintensity on MRI of your left nasal cavity indicating that infection is probably still there.
Those symptoms indicate cranial nerves involvement and more exactly the fifth or trigeminal nerve.
This and other cranial nerves are susceptible to infection too, but can be damaged by autoimmune processes as well.
What to do: in my opinion, trying to isolate the microorganism (s) that is causing infection by testing the blisters material.
A rigid cervical collar for 4 to 6 weeks with the hope that C7 fracture will consolidate and after that period, physical therapy of the neck muscles.
MRI films to be discussed with an ENT Doctor.
Veins enlarged at arm and probably at face could be related to autoimmune processes.
All these issues should be discussed with your primary care Doctor.
Hope this helps. Best regards.
Facial symptoms not related directly to cervical condition.
Detailed Answer:
Hi again XXXXXXX
I have examined both x-ray films.
There is a fracture of back enlogation (spinous process) of C7 that justifies the symptoms related to stiffness and pain on neck and base of the head (skull).
This pain is most probably caused by fatigued and spasms of neck muscles trying to keep fracture unmovable ( a compensatory mechanism ).
I don't see any fluid collection into the neck or cervical column that may raise the suspect of infection (spondylodiscitis), but since there was improvement after antibiotics use, this possibility cannot be excluded totally neither.
Discs spaces between vertebrae C5-C6-C7 seems to be reduced and this justifies arm pain (probably pinched nerve).
There are degenative changes of thoracolumbar column (small bone spurs) supporting spondyloarthritis as a diagnosis.
Facial pain and sensations seem no to be related to cervical condition.
Probably there was sinusitis that cleared up after abscess treatment with antibiotics.
However, there is still hyperintensity on MRI of your left nasal cavity indicating that infection is probably still there.
Those symptoms indicate cranial nerves involvement and more exactly the fifth or trigeminal nerve.
This and other cranial nerves are susceptible to infection too, but can be damaged by autoimmune processes as well.
What to do: in my opinion, trying to isolate the microorganism (s) that is causing infection by testing the blisters material.
A rigid cervical collar for 4 to 6 weeks with the hope that C7 fracture will consolidate and after that period, physical therapy of the neck muscles.
MRI films to be discussed with an ENT Doctor.
Veins enlarged at arm and probably at face could be related to autoimmune processes.
All these issues should be discussed with your primary care Doctor.
Hope this helps. Best regards.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Thanks. Re stubborn sinusitis possibility, how does normal WBC factor in? Could my body be adjusted if this has gone on for months?
I will try to get the blisters tested. Does it make sense to do a sinus swab?
For antibiotics, last time APO-AMOXI CLAV was used. Would it make sense to try something else, and, if so, any recommendations?
I will try to get the blisters tested. Does it make sense to do a sinus swab?
For antibiotics, last time APO-AMOXI CLAV was used. Would it make sense to try something else, and, if so, any recommendations?
Brief Answer:
Best treatment way is to identify the cause first.
Detailed Answer:
Hello again XXXXXXX
If active sinusitis, WBC should be elevated, if chronic sinusitis WBC count may result near normal ranges.
The best way to treat an infection is to identify first the causing microorganism(s) and to test sensibility of it against antibiotics.
So, a sinus swab could help in this case.
The treatment should be started after the identification of cause.
About neuralgic pain and sensations on face, carbamazepine is a good possibility to control those symptoms.
Hope this helps. Take care.
Best treatment way is to identify the cause first.
Detailed Answer:
Hello again XXXXXXX
If active sinusitis, WBC should be elevated, if chronic sinusitis WBC count may result near normal ranges.
The best way to treat an infection is to identify first the causing microorganism(s) and to test sensibility of it against antibiotics.
So, a sinus swab could help in this case.
The treatment should be started after the identification of cause.
About neuralgic pain and sensations on face, carbamazepine is a good possibility to control those symptoms.
Hope this helps. Take care.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Aha. Chronic sinusitis could have an almost normal WBC count. That is what makes everything make sense. My wife is asking for a referral to an ENT for swabs.
The squealing in my ears is the worst today. I keep working by taking ibuprofen, but feel more disoriented every day. If we have to take preventative measures before we see the ENT, if not the same apo mox clav, anything you would suggest that might attack from a different angle - be effective against what it was not?
(I would like your input on the auto-immune question as well, since there is data worth considering, and will ask a separate question.)
The squealing in my ears is the worst today. I keep working by taking ibuprofen, but feel more disoriented every day. If we have to take preventative measures before we see the ENT, if not the same apo mox clav, anything you would suggest that might attack from a different angle - be effective against what it was not?
(I would like your input on the auto-immune question as well, since there is data worth considering, and will ask a separate question.)
Brief Answer:
ENT results should guide treatment possibilities.
Detailed Answer:
Hello again XXXXXXX
Usually elevated WBC are seen in the acute phase of an infection, as a result of the body fighting it, as the infection is controlled, or confined, gradual decline in WBC count is seen.
In addition, there are certain infections (some viral ones) that decrease the WBC count too, besides other effects on health.
At the moment, in my opinion, symptomatic treatment should continue until the infection is confirmed and the cause is isolated and since Ibuprofen is working, is fine.
As I mentioned before, your symptoms seems to be nerves dysfunction related, so carbamazepine and vitamins B group supplements should help in improving symptoms.
Further treatment possibilities should be evaluated after ENT opinion.
Hope this helps.
ENT results should guide treatment possibilities.
Detailed Answer:
Hello again XXXXXXX
Usually elevated WBC are seen in the acute phase of an infection, as a result of the body fighting it, as the infection is controlled, or confined, gradual decline in WBC count is seen.
In addition, there are certain infections (some viral ones) that decrease the WBC count too, besides other effects on health.
At the moment, in my opinion, symptomatic treatment should continue until the infection is confirmed and the cause is isolated and since Ibuprofen is working, is fine.
As I mentioned before, your symptoms seems to be nerves dysfunction related, so carbamazepine and vitamins B group supplements should help in improving symptoms.
Further treatment possibilities should be evaluated after ENT opinion.
Hope this helps.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
