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Differences in MRI's, why?
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Differences in MRI's, why?

Two years ago I had a MRI that showed L3-4 was unremarkable. The conus medullaris is normal in appearance. At L4-5 everything looked ok except for mild facet arthropathy bilaterally. At L5-S1 again all seemed well with moderate bilateral facet arthropathy. Conclusion, Facet arthropathic changes at L5-S1 and to a lesser extent at L4-5 w/o disc herniation, root displacemet or central canal stenosis,

Two Days AGO at a different facility: Alignment is normal. Vertebral marrow signal and vertebral body height are intact. The conus terminates at the level of L1 and demonstrates normal intrinsic signal and normal caliber. No spinal canal stenosis, cord compression or disc herniation is demonstrated. There are mild degenerative spondylitic changes at L3/L4 and L4/.L5 with minimal loss of disc sinal intenstiy. The intervertebral foraminia are widely patent. visualized soft tissues are normal.

It appears that the moderate arthritis in L5/S1 has disappeared. Why is there such a big difference in reading and does anything in this new reading show anything worse.  I have had increase with pain in back and legs that is why we got a new MRI. What is spondylitic changes? I keep seeing spondylotic(sis). Please any advice is appreciated.
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I believe what has happened with part of your scan report is the first one numbers the facet joint arthritis locations (that's where those butterfly-shaped bones come off the vertebrae on the back side) in a different way than the second one numbers the spondylosis of the vertebral bodies (the actual round-shaped bones).  The two terms, facet arthritis and spondylitic changes, are often mentioned together or are relating to each other in some fashion.  One radiographer may notice the facet joints are goofed up, but since the vertebrae are showing some changes too, which can typically include as an example the slight slippage of one bone over another, they just put the whole thing together as spondylitic changes.  

I think for you, the facet arthritis was the most noticeable difference in your spine when the first MRI was done.  But since then, the situation has worsened, and now your spine has become spondylitic, and that means the whole works, the butterfly-like joint, the position of the vertebrae in relation to each other, and the general degeneration of the spine, this has all become one big inflammed area, and thus an arthritic and stiffened condition from L3 down to S1 has taken place and is making your life miserable.

These things can be further explained by whomever ordered this scan, and for the life of me I do not understand why it has become almost standard to give a patient a copy of their radiology report when only people who are familiar with all those terms can make heads or tails of them.  But this is why you normally will have a followup appointment set up with the doc who ordered this thing, so he can explain what's going on to you, as well as answer questions.  

The good thing about your report is, not too many wild changes have happened to nerve roots, the spinal canal, or adjacent structures, because then you may wind up needing stabilization with surgery.  But at this point, to me anyway, there is no question but you are uncomfortable, which is putting it mildly, and while physical therapy to strengthen muscles and medicines will help, it's no fun to have a goofed-up lumbar spine. .
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I believe what has happened with part of your scan report is the first one numbers the facet joint arthritis locations (that's where those butterfly-shaped bones come off the vertebrae on the back side) in a different way than the second one numbers the spondylosis of the vertebral bodies (the actual round-shaped bones).  The two terms, facet arthritis and spondylitic changes, are often mentioned together or are relating to each other in some fashion.  One radiographer may notice the facet joints are goofed up, but since the vertebrae are showing some changes too, which can typically include as an example the slight slippage of one bone over another, they just put the whole thing together as spondylitic changes.  

I think for you, the facet arthritis was the most noticeable difference in your spine when the first MRI was done.  But since then, the situation has worsened, and now your spine has become spondylitic, and that means the whole works, the butterfly-like joint, the position of the vertebrae in relation to each other, and the general degeneration of the spine, this has all become one big inflammed area, and thus an arthritic and stiffened condition from L3 down to S1 has taken place and is making your life miserable.

These things can be further explained by whomever ordered this scan, and for the life of me I do not understand why it has become almost standard to give a patient a copy of their radiology report when only people who are familiar with all those terms can make heads or tails of them.  But this is why you normally will have a followup appointment set up with the doc who ordered this thing, so he can explain what's going on to you, as well as answer questions.  

The good thing about your report is, not too many wild changes have happened to nerve roots, the spinal canal, or adjacent structures, because then you may wind up needing stabilization with surgery.  But at this point, to me anyway, there is no question but you are uncomfortable, which is putting it mildly, and while physical therapy to strengthen muscles and medicines will help, it's no fun to have a goofed-up lumbar spine. .
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Thank you for your input. I was hoping to hear back from a doctor, but you told me what I had pretty much figured out for myself, just didn't want to accept it. The DR. who ordered it, instead of making an appointment for me to come back to him, has passed it on to the rheumetologist who has diagnosed me with Fibromyalgia as well as this other mess. I thought that was pretty bogus, but I will get someone to clarify it for me....Thank you for taking the time to share your knowledge with me :D  It is much appreciated!
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Actually, Supermom, there are a few docs in this patient-to-patient forum who will answer some posts.  But if you indeed would like the services of a doctor on this website for sure, there is a part of the forum list that says, "Ask The Doctor," where I think for a small fee, a doc will post an answer back to you.

As for your rheumatologist now being charged with explaining the MRI, this he can certainly do, for they order stuff like this all the time.  However, if the rheumy sent you to a neuro for evaluation, the neuro dropped the ball on that one.  I imagine your rheumatologist is concerned for your lower back pain and wanted to find out if you were a candidate for surgery, so he would not provide less than adequate care to you.  I wish I knew WHAT should be done or how this could be treated based on your MRI.  All I know is docs vary in treatment of these things, from zero, to moderate treatment like medicine, physical therapy, possibly a back brace, that sort of thing, sometime shots in the spine will help for short periods, on up to surgery.

I hope someone will at least give you better medicines, perhaps, than you are receiving now.  That is actually my situation at the moment, and I too have an MRI that shows facet joint degeneration, which at my age, in my 60s, is pretty typical, altho I was in a car accident years ago that eventually disabled me, and I thought my latest lower back pain was part of that, but my neuro has not advised me one way or the other about that, and is in fact reluctant to give me better pain control than I have!  

By the way, this may have nothing to do with your situation, but you can get SS disability just for fibromyalgia, and that coupled with a tore-up back as borne out by the MRI should get you that financial assistance, if you need it.  As for medicines that might help, for a while, Lyrica helped my lower back pain for a couple years, but that's why I'm in the middle of trying to get better pain control, it's become worse and I don't know why, and my doc is being stingy about helping me out.  SIGH.
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