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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Marrow Signal Mildly Heterogeneous Without Folcal Suspicious Abnormality Mean? Why Am I Suffering From Pain?

Hi I have a few questions on my back findings... what is marrow signal is mildly heterogeneous without folcal suspicious abnormality? also... says in the report there is persistent moderate levocconvez lumbar scoliosis .. Light anterolisthesis is noted at L3 and L4. There are mile degerative endplate signal changes at L3-L4 and L4 and L5. The conus medullaris terminates at upper L1 and appears normal in contour and signal. says also there is mile bilateral facet antrhropathy. L2 -L3 and moderate right and minimal left neural foraminal stenosis . L4-L5 Severe dist height loss and desiccation . Circumferential disk bulge indents the ventral thecal sac without significant central canal stenosis. I have pain.. have had it for years but its accentuated the last year or so.. sit.. walk.. stand .. lay down.. back up and sit etc.. I don t take anything for it.. put heat on it which is maybe not the thing to do but it makes it tolerable when I have to stand for durations of time like 9 hours on concrete.. lol.. got to looking at this thing and was wondering waht that marrow signal thing was.. the rest is just garble farble to me outside of the word pain.. hah... the marrow part was as follows: Marrow signal is mildly heterogeneous without focal suspicious abnormality. There are mile degenerative endplate signalchanges at L3-L4 and L4 L5 hey thanks... didnt know there was a live Doctor here... I appreciate your answer...
Fri, 19 Apr 2013
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Radiologist 's  Response
Hi.

In early life (till about 20 years age), the bone marrow within the vertebrae is mainly blood (erythroid) which appears relatively dark on MRI. As age advances, this erythroid marrow is replaced by fat which appears bright on MRI (T1). However, this replacement is patchy. So, a middle aged person (around 20-40 years) may have a heterogenous or patchy appearance of marrow signal on MRI. Sometimes though, the fat marrow may get replaced by other tissues like tumor cells (metastases), which appear as focal dark areas on a uniform bright background and may appear patchy. Thus, the mention of 'no focal suspicious abnormality'in your report ruling these out.
As for the rest of the report, these are all degenerative changes (related to age and lifestyle) and since there is no mention of any nerve root compression, its probably not something to be too worried about. Appropriate exercise, physiotherapy, weight reduction, use of a lumbar support belt, etc. would help reduce your pain.
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What Does Marrow Signal Mildly Heterogeneous Without Folcal Suspicious Abnormality Mean? Why Am I Suffering From Pain?

Hi. In early life (till about 20 years age), the bone marrow within the vertebrae is mainly blood (erythroid) which appears relatively dark on MRI. As age advances, this erythroid marrow is replaced by fat which appears bright on MRI (T1). However, this replacement is patchy. So, a middle aged person (around 20-40 years) may have a heterogenous or patchy appearance of marrow signal on MRI. Sometimes though, the fat marrow may get replaced by other tissues like tumor cells (metastases), which appear as focal dark areas on a uniform bright background and may appear patchy. Thus, the mention of no focal suspicious abnormality in your report ruling these out. As for the rest of the report, these are all degenerative changes (related to age and lifestyle) and since there is no mention of any nerve root compression, its probably not something to be too worried about. Appropriate exercise, physiotherapy, weight reduction, use of a lumbar support belt, etc. would help reduce your pain.