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chronic bilateral flank pain.
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chronic bilateral flank pain.

I am a 36 yo female with no past medical history. 3 kids and 140 pounds. I have had many tests for this bilateral side pain. It is much worse on the right but also present on the left side.  It is under and around my lower ribs and on my sides. Sometimes it moves around the front or to the chest. It is present every day some days are worse than others. It is a kind of dull nagging pain that is somewhat intermittent. Sometimes there is a sharp jolt of pain but mostly it feels dull and deep.The pain is worse with sitting and especially when lying down.Some days it really interferes with my life.I take motrin and that helps a little. I do have to urinate very frequently. (15 times per day and once or twice at night). I went to my gynecologist and everything was ok. The past few weeks my appetitte has been off and I have lost 5 pounds. I am very discourgaged and unhappy that I could have pain this long with no apparent cause. I went to a chiropractor and physical therapist who both couldn't help me  
The pain began in Feb 2006.  I thought I had kidney stones so I went to the ER. They did a noncontrast ct scan. It was negative. I do have persistant microhematuria which I have had for at least 8 years.(noticed while pregnant) I next went to a urologist because I thought the side pain must be related to the hematuria.  He did a cystoscopy (march) which was negative other noticing that I have abnormal ureter insertion in the bladder (stadium shape).I then had a VCUG. That was negative other than "moderate urine residual".  Next they sent me to a nephrologist.  I had a renal sonogram.(May) It was negative.  I had blood work which was negative (bmp, complement, 24hour urine).  Next I had a renal angiogram (july) because they also noticed some hypertension.  It was negative also.
Now a couple months went by and I just continued suffering with no reason. I decided to try an internal medicine doctor.  He thought maybe it was something in my thoracic spine.  I had cervical/thoracic/lumbar x rays which showed "cervical flattening which is non specific may be related to paraspinal spasm" and a "paraspinal calcification at t11 and t12"  Also he notices that I have more back muscle bulk on the right side. So now the doctor says that there is something in the muscle like an abscess or hematoma. So I have an MRI of the Thoracic and lumbar areas (October). When I go for the mri, I talked to the tech and she says they only look at the spine not the muscle so I tell her the problem and she says she will try to add that area in.  Now the mri comes up negative except for some L5 annular tears and mild protrusion which isn't the area where I have pain so it is not relevant. It says that paraspinal areas are normal. My questions are:
1.  Was the spine mri the right test to do? How could the x ray show something and not the mri?
2.Could something bad like tumors have been missed?
3.Do you have any suggestions on where to go from here?
Thank you. I appreciate it.
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To answer your questions:
1) Given the negative testing thus far, evaluating the spine with an MRI was reasonable.  Normally, the MRI is a more sensitive test than an x-ray and would be able to show more.

2) Given the tests already done, it would be unlikely that a tumor was missed.  Further evaluation can be done with a contrast CT or MRI of the abdomen.

3) As mentioned above, I would consider further imaging, including an MRI or contrast CT of the abdomen and pelvis.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
ask your doctor about liver and spleen swelling maybe from hepatitis
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