Confused with doctors letter

dizzylizzy13
dizzylizzy13 Member Posts: 16
edited 23. Jul 2013, 13:56 in Living with Arthritis archive
I am confused with the copy letter from my hospital doctor to my GP. I have been having back stiffness and pain for over a year and asked for an MRI scan, which I was given (this was requested by Neurology).

The letter reads. 'I am pleased to inform you that this lady's MRI of the lumbosacral spine revealed degenerative changes, but there was no canal stenosis or nerve root compression. The results have been conveyed to the patient over the phone as she was concerned'. I then requested a copy of the MRI and am confused as the doctor told me that it didn't show much. Does this just mean normal wear and tear for someone of my age (55)?

Below is the basis of the MRI.

L3-L4: Degenerative disc disease with dehydration and bulging, in combination with a flavum/facet hypertrophic changes resulting in mild canal stenosis. Also two small non compressive bilateral facet joint synovial cysts demonstrated.
L4-L5: Degenerative changes with end plate osteophytes, disc dehydration, bulging and small central protrusion with annular tear, in combination with flavum/facet joint hypertrophic changes resulting in dural sac indentation and touching on the exiting S1 roots, but no convincing nerve root compression demonstrated (ax T2 image 14)'

I would welcome your comments.

Comments

  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    Every profession has its own language and the medical profession is no exception. Doctors writing to other doctors will use the correct terms and I must admit this is one reason I have never been bothered about being copied in.

    I am not a doc, and therefore don't speak doctor, but I reckon it means that things are changing but not to a necessarily alarming degree There are degenerative changes (probably related to ageing), the spine does compress with age as the 'padding' between the discs dries (that's why older people shrink with age) you have two synovial cysts (one on each side of the spine, the synovial fluid is the lubrication between joints, whereas the synovium is a membrane covering the bones I think :? ) so my best guess is that the cysts are within that. As for the hypertrophic, flavum and facet points, dural sac indentation etc I have not a clue. Sometimes google can be a friend.

    So, to sum up in very basic layman's terms, stuff is happening and it hurts. We all know that feeling well. DD
  • Boomer13
    Boomer13 Member Posts: 1,931
    edited 30. Nov -1, 00:00
    Hi;

    I'm no doc, but my best friend is suffering with spinal cord troubles. I may be able to help with definitions.

    Stenosis refers to narrowing of the spinal canal; leads to pressure on the spinal cord and/or major nerves branching off (nerve roots).

    Facet joints are between the processes (bones that stick out off of the spine) of the spine that allow stability during twisting movements of the back.

    The Dural sac is a tough outer membrane that covers the spinal cord.

    Osteophytes are boney growths that appear with arthritic changes, inflammation etc. When they appear on the vertebrae, they can press on nerve tissue causing pain and neurologic symptoms.

    Annulus is part of the intervertebral disc (cushion between vertebrae). Small tear here results in a bulge (herniated disc). A very common back injury.

    Hope that helps.
    Anna

    PS It can be very helpful to look at a 3D model of a spine. If you attend physiotherapy, they should have one you could ask to look at and help you identify various structures.
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    Aaaaagh! I forgot the osteophytes - I have those in (on?) my knees and ankles, apparently they occur as my body tries to repair itself (maybe as recompense for destroying itself? :lol: )

    Boomer13 has given a much better answer than me but either way I hope we've helped. DD
  • barbara12
    barbara12 Member Posts: 21,274
    edited 30. Nov -1, 00:00
    Hello
    I had an MRI well 2 on my back last year, and the bulging disc and a stenosis is though to be causing my back pain, my consultant said that he has seen MRIs with not much showing up and the person has been in a lot of pain...he had also seen some with protruding disc and stenosies that hadn't much pain at all...sorry if I rambling...but it is so complex..and I do hope you get some help very soon x
  • dizzylizzy13
    dizzylizzy13 Member Posts: 16
    edited 30. Nov -1, 00:00
    Thank you all for your replies. I saw my gp today for a translation and all I got was I have 'wear and tear'. What I don't understand is that the letter from the hospital doctor said there was no stenosis yet on the scan it 'resulting in a mild stenosis'. Does that mean it so insignificant it doesn't matter? I find it all so confusing.
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    Is this the same doctor who interpreted the MRI scan? If so then he does appear to be contradicting himself so this confusion could form the basis of a letter from you to him requesting clarification. DD
  • dizzylizzy13
    dizzylizzy13 Member Posts: 16
    edited 30. Nov -1, 00:00
    the hospital doctor wrote there is no stenosis. But the summary at the bottom of the mri report said there is no SIGNIFICANT stenosis. So I was wondering as it clearly says on the MRI mild stenosis if this could get worse. I have already been diagnosed after having an MRI on my knees as having severe osteoarthritis of the knee cap with cartilage loss when they told me there didn't seem to be a problem other that some crepitus. I am under the neurologists now because they seem to think I have a proximal myopathy in my legs (due to have a MRI on my lower legs next week). I am therefore wondering if the stiffness and pain in my lower legs is anything to do with my spine but the doctor who wrote the follow up letter following my spine MRI doesnt seem to think so. All very confusing.
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    None of us can see into the future and that includes our doctors. Mild stenosis hints at the beginnings, the early stages, of troubles but who knows if it will worsen? We are all different in our experience of arthritis, each of us is unique and the doctors don't necessarily have the answers to our questions. Neither do we. Yes, it is confusing but over the years I have learned to ignore the stuff I don't understand and just go day-by-day with the troubles that are bothering me. It's not easy, dizzylizzy, we all understand that. DD

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