"Rule in" vs "Rule Out"

[rogers5]

JUst read this on another post and it came up this week for my LP.  What is the difference between a "rule in" test and a "rule out test".  The order for my LP said "R/O MS."
Thanks

[Sidesteps]

I apologize, I do not know all your history but I wanted to give you the information I received regarding my LP (which was also negative.)

My MSologist indicated that a negative LP does not indicate you do not have MS. She told me that it could mean is that you are very early or it's a more benign disease process.

Lupus is similar. It's very difficult to diagnosis and can take some time for the test to reflect all the necessary diagnostic criteria to make the blood test positive.  It is also a test that is best taken in the active phase of the disease when inflammation is highest.

My mom has many positives but not all of the criteria is met. They told her "at this time" it is not lupus but she does have some sort of auto-immune disease. They just don't know which one so she is on a "watch and wait" list. Strangely we share a lot of the same symptoms but I am ANA negative along with no inflammatory factors.

[rogers5]

Well I got the spinal tap results back. Negative. I dont know whether to be happy or sad.  Iguess glad because the doctor says "no evidence of inflammation or MS" but from your experiences that may not be true. Also, If its not ms then what the heck is going on with me?  I guess im in the waiting game?? :(

[Guitar_grrrl]

I'm glad your LP went fairly smoothly, and I'm glad the headache resolved with the added water :-)  

I, too, had a negative LP, and was diagnosed by neuro exam, history, and a suggestive but not slam-dunk MRI-brain.  The MRIs of my C and T spine were negative, even though my neuro exam indicated spinal lesions.  I was confidently diagnosed.

[rogers5]

Thanks everryone for your input. So much t learn

Hi Shell,
Do you mean where did I have the LP? It was at the hospital.   It went well, no headache after although I did on day two and three.  Dont know is it was related but started drinking alot of water and it passed.  Yes I get what you are saying, my doctor does not think its MS, so it would then make sense that he would do it as a R/O for MS.  He said he expects for it to be clear.  I do not.  I hope it is but I know there is something really wrong :(
Thanks again everyone, Ill let you know how the results go
Lavonne

[sllowe]

Rogers5,

Hi there,

Where'd you go? And, how'd you make out with the LP?
To add some clarity - While a negative LP ALONE cannot rule out MS generally speaking and based on the stats that some MSers csf is negative..... the results of your personal LP results added to other clinical and test findings may rule out MS based on the totality of your doctors findings.
Remember, MS is a clinical dx, so like the personal examples provided above meant MS or not for each - we are all not all exactly alike. Where some people lack evidence in one area, they may have an abundance in another.  So, each individual piece to the puzzle the doctor looks into can and does vary greatly in significance from one person to another.
-shell

[Tammy826]

My LP was negative but I had a pretty large lesion load on my MRI. My neuro says that the LP helps to diagnose but doesn't rule out MS. I agree with COBOB as I am one of the 10%.

[Sidesteps]

I was informed that my spinal tap would be the most cost effective and fastest route to diagnosis in absence of obvious (specific) MRI findings.

I do not have anything specific to MS on any of my tests. I do have my history as well as supporting signs in my clinicals and a single nonspecific lesion. In my case, I guess it would give her enough evidence to diagnose and treat.

I asked if it was negative what that meant? She said, "We would then move to full MRI's, evoked potentials and a Neuro Ophth who might be able to see things they (the Neuro's) can't."

[Sumanadevii]

After my dx I was sent for a spinal.  The neuro told me it didn't matter if I had O bands or not.  I had MS.  Period.

[COBOB]

An LP can not "Rule out" MS.  A LP with unique OC Bands, High IgG Synthesis, or MBP levels can help support a diagnosis of MS.  About 10% of People with Clinically Definite MS, have a negative LP.

Bob