MRI/X-ray results and SS

[Shaun Pang]

Have a trainee that experienced a back tweak while training. She went for an MRI/X-ray of it and decided to scan her knees as well since she used to have knee issues (went away when she started squatting). Would like to ask if the results of the scans are any cause for concern.

46 Year old, Female


MRI Lumbar spine

Technique:
Sagittal and axial T1W and T2W sequences performed

Findings:
Loss of lumbar lordosis. No spondylolisthesis is seen.
Disc desiccation at L3/4 to L5/S1.
Anterior annulus tear at L5/S1 and posterior annulus tear at L3/4 detected.
T1W and T2W hyperintense focus at L5 vertebral body, in keeping with a hemangioma.
Spinal cord ends at L1 and there is no intraspinal mass evident
L1/2 to L2/3, no posterior disc protrusion, thecal sac compression or neural foramen narrowing.
L3/4 to L5/S1, mild diffuse disc bulges abut/indent the thecal sac. No neural foramen narrowing seen.
No abnormal paravertebral mass.




X-ray of lumbar spine

Technique:
AP, lateral and both oblique views were obtained

Findings:
Loss of lumbar lordosis. No spondylolisthesis is seen.
Osteophytic lipping at L4 and L5 noted anteriorly.
No bony spinal canal stenosis evident.
Vertebral bodies and pars interarticularis are intact bilaterally.
Sclerotic focus projected over the right iliac bone that may be a calcified granuloma.
Sacroiliac joints are unremarkable, with any sclerosis or focal erosion.



X-ray of both knees.

Technique:
AP, lateral and skyline views were obtained.

Findings:
Osteophytic changes are seen bilaterally, most pronounced at the tibial spines and posterior patellae.
OSteophytes at both proximal tibiofibular joints are also seen.
Suggestion of an intra-articular loose body adjacent to the left tibial spine.
Densities related to the superior aspect of both patellae that may be a result of chronic quadriceps tendinopathy.
SKyline view shows bilateral patellar subluxation, more pronounced on the left.
Normal bone density.
No dystrophic calcification is seen around the knee joint.


Thank you for the feedback.

[Nick Delgadillo]

No idea. Let's see if someone can interpret these.

[vanslix]

One would have to know the full clinical picture, history and physical. It's not prudent to base judgment solely on this.

[Tom Campitelli]

Getting an MRI or other medical imaging procedure on body parts that do not ail you is generally a very bad idea.

[John Petrizzo]

One would have to know the full clinical picture, history and physical. It's not prudent to base judgment solely on this.

Couldn't agree more with this. There are plenty of people out there with terrible imaging and minimal pain/dysfunction. I would base her training moving forward on her symptoms, not her MRI results.

[davidmyer]

And her spine mri is essentially negative. There is no such thing as a normal mr. There will be readings of many things. For her, she has several minimal disc bulges---nothing, annular tears---who knows what significance, and no neural compression. There is nothing to operate on here (the orthopaedic surgeon In me speaking). Knees---pretty standard arthritic picture painted. PF joint, some mal tracking evidence (from wear pattern) perhaps she had an old patella dislocation, or that's just her anatomy, exacerbated by not strengthening her quads.

[Shaun Pang]

Thank you everyone for the feedback and advice.

[jason1987]

(the orthopaedic surgeon In me speaking)

exacerbated by not strengthening her quads.

You doctor, have earned my respect.