Neck Pain + MRI Results

[ryansmom01]

Hello!  I have been experiencing moderate to severe neck pain for ~3-4 months; progressively worsening. I initially thought the cause was my pillow; increased exercise; poor form during exercise, age, etc. Finally, so painful that I visited my primary care dr. thinking it was a disc problem - dr. ordered an MRI. I am also experiencing periodic burning sensation in left ring/pinkie fingers and occasional numbness along with a general clumsiness or stiffness in both hands. Based on MRI results (as follows), dr. ordered blood work, thyroid ultrasound, and a visit to the neurosurgeon whom I can't get in to see until the end of July. Impressions from MRI:
1. Linear, tubular focus of signal abnormality w/in the cervical spinal cord at the C6 and C7 levels which may reflect mild dilatation of the central canal of the spinal cord vs. a small syrinx. Neoplasm is considered unlikely; however, a followup gadolinium enhanced MRI of the cervical spine is recommended.
2. Mild degenerative changes of the cervical spin as described w/o significant spinal canal or neural foraminal stenosis. At C6-C7, there is a tiny central disc herniation which mildly indents the thecal sac w/o nerve root impingment.
3. 5 mm focus of signal abnormality w/in the right thyroid lobe, incompletely characterized on the study. Correlation w/thyroid ultrasonography is recommended.

I had the ultrasound which confirmed the mass on the thyroid; tech said 'nothing to worry about'. No results are back frm the bloodwork and the dr. hasn't yet ordered the gadolinium enhanced MRI. I have never had any thyroid or neck problems; however, I was in four car accidents between 1983 - 1998.  In two of the four, I walked away in a cervical collar but ER visits showed no damage.  I have had no previous issues with my legs, arms or hands and I am a healthy 44 yr old female. Although I am aware of the neck pain most of the day, it occurs most severely when reclined making restful sleep a very difficult task. I realize I am VERY early in the process of diagnosis but I never expected to get these type of results when I thought I had a structural problem.  What do I have to be scared of? Thank you in advance for any insight or advice!

Ryansmom

[ryansmom01]

Thanks very much for your comments and insight - most appreciated.  I will *try* to relax between now and my neurosurgeon appt. as you suggest!  I have been driving myself nuts with the 'what-ifs'.  I'll update as I learn more - thanks again!

[kittyluv1]

Your MRI results indicate the need for further diagnostic tests as the obtained films are suggestive of certain conditions which can not be definitively diagnosed at this time.
The need for an MRI with contrast will provide more clarity and allow the doctors to correctly determine any pathology that might exist.  And at the same time, if no pathology exists.

Going through the process is more anxiety producing than having the procedures done.
The waiting for results can seem interminable --- but having a definitive diagnosis helps avoid any unnecessary medical treatment.  An example:  mammogram shows an area that appears abnormal.  You then go for an ultrasound and if no diagnosis is clear but the area remains suspicious, the next step is a core biopsy.  Only after a final diagnosis is made of any significant pathology would further treatment ( surgical biopsy and /or  a possible mastectomy) be appropriate.

Often "masses" are identified and are essentially benign and need no further investigation.  Should it reveal a potential problem, the doctor has an arsenal of information (clear films, lab results confirming provisional diagnosis etc) that will allow effective medical treatment to be initiated. The syrinx mentioned in the MRI is identifying a fluid filled cavity within the spinal cord, but it can not be visualized with enough clarity to make a definitive diagnosis.  Thus the need for a contrast imaging study.

Your history of MVA's may or may not be related to your current symptoms.  The MRI shows some mild degenerative changes which are normal secondary to the wear and tear on our spine as we age.  At present there is no evidence of nerve involvement to account for your pain and sensory changes.

The thyroid mass will be better visualized with the ultrasound and allow the doctors to determine if further evaluation or investigation is needed.  It may be benign and the lab tests may confirm no abnormalities in the function of the thyroid,  

While you have been experiencing neck pain as your primary symptom, be aware that stress and anxiety has the potential for exacerbating the subjective symptoms --- curtailing the anxiety until objective findings are noted is the key.  Find activities that help with relaxation and ease your mind until a more definitive diagnosis is obtained.

Keep us posted of your progress.