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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
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Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Im still researching my headaches trying to figure out what

Resolved Question:

I'm still researching my headaches trying to figure out what is happening to me. Now that they have medical records online I am looking at old test results and such. Of course most of it I don't understand and I would like some help understanding some statements that are in some old MRI results. I have a history of arthritis in my neck and back. I was diagnosed with Ankylosing Spondylitas about 5 years ago. Now the doctor that diagnosed me is no longer sure and thinks that perhaps I have Hypermobile Joint Syndrome and resulting joint damage. Anyways I have had a fair number of MRI's and CT scans over the years. I have access to a few. I am thinking that perhaps my neck problem could be contributing to my headaches.

Things on MRI that I have questions about

1) There is high signal intensity on all sequences in the C2 vertebral body most consistent with hemangioma; (What does this mean?)

2) Small anterior-posterior osteophytes extending from the C5 and C6 vertebral bodies

3)IMPRESSION: Multilevel degenerative changes. There is mild to moderate disk bulging at several levels as above. This is most prominent at C5-6 centrally and towards the right with narrowing in the anterior subarachnoid space

3)MRI of SI joints says this what does it mean? Again noted is symmetric sclerosis involving the sacroiliac joints, predominantly on the iliac side of the joint.
These findings appear unchanged as compared to the prior study, and
are felt to represent osteitis condensans ilii.
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 2 years ago.
Greetings.

Following are the meaning:

1) There is high signal intensity on all sequences in the C2 vertebral body most consistent with hemangioma; (What does this mean?); hemangioma means a bunch of blood vessels. Usually these are by birth. They may occasionally cause pressure on spinal cord or nerves as they can enlarge in size with the age.

2) Small anterior-posterior osteophytes extending from the C5 and C6 vertebral bodies; osteophytes are new bone formed (also called bone spurs) due to wear and tear arthritis. This comes with aging.

3) IMPRESSION: Multilevel degenerative changes. There is mild to moderate disk bulging at several levels as above. This is most prominent at C5-6 centrally and towards the right with narrowing in the anterior subarachnoid space; Degenerative changes again are due to wear and tear arthritis. The disc which are shock absorber of the spine gets damaged / degenerated with the age and cause pressure on the nerves. You have biggest disc bulge at 5th and 6th neck vertebrae on the right side which is causing pressure on the spinal cord.

4) MRI of SI joints says this what does it mean? Again noted is symmetric sclerosis involving the sacroiliac joints, predominantly on the iliac side of the joint.
These findings appear unchanged as compared to the prior study, and
are felt to represent osteitis condensans ili
i; Sclerosis is hardening and thickening of the joint. The sacroiliac joint in pelvis is the first joint involved in the Ankylosing spondylitis. This might be the reason of the diagnosis of Ankylosing. If you did not have calcification of the joints and ligaments in the spine, Ankylosing may not be the possibility, especially if a blood test HLA B 27 is negative. This can be just wear and tear arthritis.

On the whole your spine shows degenerative changes or wear or tear arthritis. You headache can be due to this. This can be cervicogenic headache. Pain can be referred to the head from muscles, nerves, bones, joints and vascular structures in the neck.

Please feel free for your follow up questions.

 

I would be happy to assist you further, if you need any more information.

 

Dr. Arun
Customer: replied 2 years ago.
These MRI's are from January 2007. So I imagine things have not improved. The headache onset has been since January of this year. I did fall prior to the headaches. I had a CT scan because there was a concern that I had a neck fracture I of course did not. Headaches were thought to have a Neuro cause I guess because of the nature of them but I there has been no real answers yet and I am frustrated. Do cervicogenic headaches have any specific characteristics?
Expert:  Dr. Arun Phophalia replied 2 years ago.
Cervicogenic headaches have accompanied pain on the neck movements with the MRI findings of neck arthritis. The mainstay of the treatment is physical therapy. Deep electrotherapy also may help and so the chiropractic manipulations.

 

Please read the resources;

 

http://www.jaoa.org/cgi/content/full/105/4_suppl/16S

 

http://www.cinn.org/pain/headache-cervicogenic.html

 

Physical therapy is the preferred initial treatment for cervicogenic headache. The other modalities employed for the treatment are done by pain management physician and are invasive modalities. These are;

 

1) Percutaneous radiofrequency neurotomy

2) Steroid injection

 

Your physician may consider a trial of Gabapentin or Pregabalin as an initial medical treatment to see the response with the physical therapy.

 

It is privilege assisting you.

 

Dr. Arun

Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29652
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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