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Dr.Sawhney
Dr.Sawhney, Orthopedic Surgeon
Category: Orthopedics
Satisfied Customers: 6822
Experience:  More than a decade of post qualification experience
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Jodie Pias | DOB: 8/19/1985 | MRN: 4988937 | PCP: Celia R

Customer Question

Jodie Pias | DOB: 8/19/1985 | MRN:(###) ###-####| PCP: Celia R Elias-Butler, MD MRI SPINE LUMBAR WO CONTRAST - Details Narrative MRI LUMBAR SPINE WITHOUT CONTRAST, 07/24/2015 INDICATION: FALL, DISLOCATION TECHNIQUE: Multiplanar MRI images of the lumbar spine
were obtained without gadolinium contrast. CONTRAST DOSE: None. COMPARISON STUDY: No prior MRI for comparison. CT scan of the thoracic and lumbar spine dated 07/27/2014 was reviewed. FINDINGS: MRI Lumbar spine: For the purposes of this dictation, the lowest
fully formed lumbar vertebral body is defined as L5. There is partial sacralization at L5-S1. Mild degenerative disc disease at L4-L5 with mildly decreased T2 bright disc signal. A mild disc bulge at this level mildly indents the thecal sac and abuts the descending
left L5 nerve root in the lateral recess. Overall there is mild spinal canal stenosis at this level which is also contributed to by mild ligamentous hypertrophy and mild bilateral facet arthropathy. An annular fissure is also noted at this level. The remainder
of the intervertebral discs are normal in signal. The vertebral bodies are maintained in height and alignment. The marrow signal is normal. No prevertebral or dorsal paraspinal soft tissue swelling. The anterior and posterior longitudinal ligaments and ligamentum
flavum are normal. No epidural hematoma. The conus medullaris is normal in size and signal and terminates normally at the level of T12-L1. Impression IMPRESSION: No evidence of acute abnormality. Mild degenerative disc disease as described at L4-L5 in the
setting of partial sacralization of L5-S1. HIP MRI No acute fracture or dislocation of the pelvis and hips is seen. There is mildly increased amount of fluid in both hip joints. There is desiccation of the L4-L5 intravertebral disc. There is a transitional
L5 vertebra with hypertrophy of the L5 transverse processes which articulate with the sacrum. There are some degenerative changes at these articulations with associated mild bone marrow edema which is more pronounced on the right. This also could be a source
of the patient's pain. The bone marrow signal is otherwise unremarkable. The imaged musculature is grossly unremarkable without evidence of edema or atrophy. There is mild subcutaneous dependent edema in the left sacral region. The imaged tendons about the
bilateral hips are grossly unremarkable. The urinary bladder is moderately distended by urine. The uterus is present and appears unremarkable. No ovarian or pelvic masses are seen. The vagina is deviated to the right with associated tampon. There is suspected
septation within the vagina and suspected thin septation within the uterine cervix without septation within the uterus seen. The evaluation of the acetabular right labrum is suboptimal on this nonarthrogram study. However, on the sagittal images there is a
small high signal intensity cleft projecting over the anterior right acetabular labrum which may represent labral tear
Submitted: 1 year ago.
Category: Orthopedics
Expert:  Dr.Sawhney replied 1 year ago.

Hello

I am an Orthopaedic surgeon and I would be happy to help you today.

I have read the MRI reports written above.

Please ask what your question is relating to the above MRI reports.

Customer: replied 1 year ago.
I would like to know if they can be put in simpler terms. I know I have degenerative disc disease, spinal stenosis, and herniated discs, but if you could read these results and present them to me as if I was your patient that would be wonderful. My MRI that was completed in Oct 2013 was not near what this one is. I guess I am just looking for a professional explanation of what these results mean, and in terms I can understand.Thank you
Expert:  Dr.Sawhney replied 1 year ago.

I will try to explain the findings of MRI in a language you can understand.

In lumbar spine significant change is at the L4L5 disc that is the disc lying between 4th and 5th lumbar vertebral bodies.

There are changes of degeneration here.

A disc acts like a shock absorber by getting compressed when it is loaded and retaining its height when load is removed. Specialised structure of the disc helps in this. A disc is composed of an outer leather belt like covering called annulus and inner toothpaste like gel known as nucleus pulposus. The gel has has hygroscopic property meaning it can absorb water and leave it when required. When disc is loaded the gel like structure leaves water and when it is unloaded it absorbs water. When disc gets degenerated it loses this hygroscopic property.

Because of this loss the outer covering of disc this that is annulus has to take excessive strain. Overtime this can cause the disc to bulge out and may also lead to tearing or fissuring in the outer covering of annulus. This loss of disc function also causes excessive strain to be placed on ligamentum flavum the elastic structure present on the backside of spinal cord ( disc is present on front side of spinal cord) As a result the ligamentum loses its elasticity, gains bulk and tends to infold into the canal causing stenosis. This also produces excessive stress and strain on the facet joints which form a triple joint complex along with the disc. This causes the degeneration of facet joints making them painful.This has happened in your case as well. But good thing is that the changes are mild in your case.

Another finding which may be responsible for pain in your case is the prominent transverse process of fifth vertebral body which is rubbing on to sacrum. This has produced bone edema in the area greater on right side. Transverse process is a bony extension on the side of vertebral body.

There is a probability of a labrum tear in the Hip as well.

Feel free to ask any follow up questions.

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