Hi all.
I'm concerned that I should seek a 2nd opinion. I was diagnosed with osteoarthritis yesterday. I'm 22.
I was in a bad car accident November 26th, 2008. Full work up done after the accident, x-rays of most major joints and entire spine. No one said anything about arthritis at that time.
I had a spine MRI performed in late March. Now all of the sudden I'm riddled with arthritis, and the degeneration is compressing discs and nerves.
My Orthopedist seems to feel that the arthritis is not related to the wreck. It's my understanding that trauma to any joints can lead to the onset of arthritis. I have never had the kind of problems I'm having until after the accident. Furthermore, he does not feel it necessary to do any further testing to rule out underlying causes.
My doctor is generally a bright guy. I like him, great doctor. But I feel like I need to respectfully disagree with his opinion that it isn't related to the accident due to my medical history - I've never had any constant joint pain anywhere except my ankle that's given me problems since I twisted it as a kid.
Would it be fair to present my case to another orthopedist with my opinion for review? If it's as advanced as my orthopedist is leading me to believe, shouldn't it have been clinically diagnosable with x-rays alone? Is it fair to argue that subclinical arthritis was exacerbated by the trauma? X-rays of my cervical spine revealed significant whip-lash immediately after the accident.
Opinions appreciated.
Hi and welcome to Spine-Health.
If you have any questions, feel free to contact (PM) any one of the Moderators here Priestess , Bruce , Paulgla , DiLauro
Again welcome.......Paul
For an introduction, Click on :
Welcome To Spine-Health
_______________________________
It is always OK to get a second, third, or even forth opinions and your doctor should have no problem with that and even encourage it if you feel it necessary.
I am 51 and was in a bad car accident when I was 19. About 10 years ago I started to have really bad osteo arthritis. There is no family history of OA so I am confident the accident is what caused my body to 'rebel' years later. I am not a doctor so I can't give an opinion if 6 months is too short a time frame for the severity of OA you have.
If I were in your shoes I would get a second opinion for sure. Is there a court case and possible settlement involved in your case? If there is you will need to have the doctors on your side.
Good luck and PM me if you want to talk.........Paul
Cervical stenosis and myelopathy (most symptoms permanant), DDD, OA, 16 surgeries to date (including 3 level cervical laminectomy, bilateral knee replacements, A-C joint resections in both shoulders), 19 MRI's, and many many many cortisone shots and ESI's
The information provided by members of Spine-Health should never be considered as formal medical advice. It is recommendations based on member's personal experiences only.
This can vary from person to person, so do not take comments as medical facts or rules
Suicide Help Resources
SUICIDE HOTLINE:
USA: 1-800-784-2433
UK : 08457 90 90 90
“Without a family, man, alone in the world, trembles with the cold.”
Thank you kindly for the response.
I did retain an attorney immediately after the accident. I was rear-ended by a tractor trailer. So there is litigation pending.
It simply seems bizarre to me that osteoarthritis of my spine has not turned up on previous imaging studies. The ER technitians said everything looks great on the x-rays aside from whip-lash injury. My orthopedist also did another full series of x-rays at the start of my treatment, and concurred with the ER technitians as to everything looks great except from the whip-lash. So I'm alarmed that only now is anyone indicating arthritis. Also, my ortho indicates that there are artifacts/fragments of some sort, which is why I was diagnoised with arthritis. I really don't know alot about joint/bone health.
It is my understanding that clinical arthritis is usually detectable with x-ray studies.
I'll definitely be seeking a 2nd opinion.
OK I was able to obtain a copy of the MRI report.Maybe this will provide some additional insight to the medicalese fluent. Thankfully I type 100 WPM so typing this up isn't gonna take 4 hours. I'd also like to reiterate there were NO ABNORMALITIES on ANY x-rays immediately subsequent trauma.
Technique - Multiple pulse MRI sequences were performed in multiple planes through the cervical spine without administration of intravenous contrast.
Findings - There is no evidence of acute fracture, subluxation, or dislocation. The vertebral body heights, intervertebral spaces and alignment of the spine are maintained.
The prevertebral soft tissues are within normal limits.
At C1-C2 - No abnormalities are seen.
At C2-C3 - There is no evidence of disc herniation. The spinal canal and neural foramen are patent.
At C3-C4 - There is no evidence of disc herniation. The spinal canal is patent. There are mild hypertrophic changes seen in the uncovertebral joint causing mild right neural foraminal stenosis, the left neural foramen is patent.
At C4-C5 - There is no evidence of disc herniation. The spinal canal is patent. There are mild hypertropic changes seen in the uncovertebral joint causing mild right neural foraminal stenosis, the left neural foramen is patent.
At C5-C6 - There is a central disc osteophyte complex abutting the ventral aspect of the cord and causing mild cord flattening. There is mild to moderate stenosis of the spinal canal. The neural foramens are patent.
At C6-C7 - There is a large central disc osteophyte complex abutting and causing flattening of the ventral aspect of the cord with mild to moderate stenosis of the spinal canal. The neural foramen are patent.
At C7-T1 - No abnormalities are seen.
There is no evidence of cord edema or cord compression.
Impression:
1. No evidence of acute fractures.
2. Central disc osteophyte complexes seen at C5-6 and C6-7 causing mild to moderate stenosis of the spinal canal and abutting and causing mild flattening of the ventral aspect of the cord without cord compression or edema.
3. The remaining intervertebral disc spaces demonstrate no evidence of disc herniation and the remaining portions of the spinal canal are normal in caliber.
Comments?
Right now my symptoms are as follows;
Coldness/tingling/pain down left arm. This sensation may affect either arm, radiating down the back of my arm, very tender towards the elbow, very tender in the wrist and coldness/tingling/tremor in fingertips. Does not affect both sides at the same time, does migrate, does vary in intensity and sensation severity.
Significant discomfort across left shoulder. May also affect right shoulder, as noted above. Does not affect both sides at the same time, does migrate, does vary in intensity and sensation severity.
Significant discomfort in the neck right above that large-ish bone that usually kind of sticks out on people, C7? T1? Something like that. Logical location according to MRI report.
Any insights would really be appreciated. I need help with this and some direction as to my next step in seeking relief.
I'll make this short. I have severe OA (osteoarthritis) in my spine and also throughout my entire body. I have had a few injuries and have "played hard"
in my younger years. But the cause of my OA is genetic. If you want to get
answers seek a Rheumatologist, I am so glad I was referred to a very good
rheumy several years ago. Get a referral or research finding one on your own,
just do it so you can get the answers you need.
Take care,
Ranger
Hi Ranger, thanks for the comments. I certainly live hard and play hard, and I'm not going to let this slow me down! At this point I guess I just have to find a good doctor that takes me seriously in regards to pain and a couple of 2nd opinions as to the cause.
and just a general rant;
What I take away from the MRI report and the images (retained a copy of the CD also) is I have 2 bulging discs that have calcium deposits and a 2 more that aren't real happy.
ALso took a 2nd look at the digital copy of the X-rays I retained from the ER. My humble opinion, without being a doctor, is that if this wasn't due to the accident, this should have been visible on x-ray based on the severity of whiplash at the time of the accident. Without being dislocated, I had quite the straightening of my c-spine.
I'd like to add that I have always been generally healthy, the only real bizarre malady was a kidney stone a few years ago. I'm 5'4'', 105lbs, had a late "growth spurt" and grew by a full inch when I was 17. All physicals have always been a clean bill of health, I eat well, I take vitamins daily... this is just so bizarre considering I've been doing everything right my whole life.
*headdesk*
I had many of the same symptoms you are having when I had a large herniation pressing on my spinal cord. But in your case a osteophyte is flattening your spinal cord. An osteophyte is a outward growth of bone, hence the arthritis diagnosis. With your cold, tingling fingers it sounds like a nerve is being irritated. Maybe you should seek a second opinion from a neurosurgeon too. Good luck,and let us know how it goes!
Faith M
L4/5 discectomy 11/98,disc decompression surgery 10/01 (failed),C5/6 fusion 2/02,L4/5&L5/S1 discectomy 4/02,C6/7 fusion 4/04, L4/5 discectomy 4/05(failed)diagnosed with permanent nerve damage,2 level lumbar fusion 1/08,C4/5 fusion 1/09 and too many epidurhal/ nerve blocks to count. Surgeon said I have 2 more fusions in my future.
I missed something in your earlier post that Faith M brought to my attention in her post, the tingling and numbness. I agree with her, it's time to see a neurosurgeon for an opinion and an EMG test. I waited a little too long when
I had similar symptoms and now I have permanent numbness/tingling in my
left hand from previous to my cervical fusion to presently.
From your reply to my post you sound like you take good care of yourself, have a great attitude, are pursuing your health issues aggressively, and you
like to hit the ground running! Don't ever let up, you inspire others here at
Spine-Health.
Thank you for sharing your experience and let us all know what you find.
Ranger
Thanks for the direction as to my next steps in seeking treatment. I will be consulting with my attorney as well to find out if she is in agreement with seeking a 2nd opinion from different specialists, to include a another orthopedist, a rheumatologist and a neurosurgeon.
I really appreciate the replies from all. Just being able to rant and know someone understands makes a difference!
If anyone is interested, here's one of the images that I think gives a pretty good look at my c-spine.
http://c3.ac-images.myspacecdn.com/images02/101/l_4e171dbe52f8434481973f...
I started taking glucosamine 750 MG, chondroitin 600 MG and MSM 1000 MG last night. If it gives me some relief, great. If not, I'm out only 18$ for a 30 day supply. I've read that MSM can help with joint/nerve/muscle inflammation. I already take daily a womens multivitamin with calcium, vitamin D and iron, along with an assortment of other minerals and vitamins. I eat fish and dairy regularly so I don't think there's any need for fish oil/omega 3/5 supplements.
I've been cleared to resume low-impact exercise, so I'll be easing myself back into my old routine of yoga x3 a week. My jogging sneakers were getting dusty! So I'll be busting those out of the closet also.
I guess the key right now is to stay fit, active and flexible.
It can't hurt to take that Cazlee, my rheumy really stresses what a good supplement it is. I have been on 1500 mg daily for a few years now. I can't say how it has helped but I don't want to stop using it to find out.
And you have the right attitude, stay fit, active, flexible, and positive.
Nice clear copy of your MRI also.
Ranger
Did you have arthritis pain before the accident?
And if not, how long after the accident did you get the MRI?
From what I've read arthritis needs time to set in, years even. I was in a car accident at 13, I'm 27 now. I think I had very mild symptoms of cervical problems between 13 and 26, but they came and went so I never really saw a doc about them. At 26, they became consistent and painful. (Below is my information). What I find confusing about my results from cervical x ray and cervical mri is that they both read something different.
Anyhow the doc thinks the accident could be my source. I did dance a lot for 8 plus years as a kid and was born with trauma , left side temporary facial paralysis , have horner's syndrome from it in my left eye...was yanked by forceps and I'm sure the left side of my neck where ironically all the pain is, probably was yanked on. Now I don't know if that can affect me now, but I wouldn't be surprised, that it would make that side of the neck more vulnerable.
I have left leg stuff like my left arm pain from my cervical. I recently got an x ray for my lumbar, showed on one disc osteophytes. Now I wonder what would show up on an MRI of the same area. I bet nothing, or something worse would be my luck.
X-rays show less than MRI's , yet my X-ray for my neck showed more and different problems..Silly radiologist.
Findings:
There are no gross abnormalities at the upper three cervical interspaces or the cervical-thorasic junction. Disc desiccation without disc protrusion is noted at T1-2. The second and third thoracic interspaces are normal.
At C5-6, there is mild to moderate disc desiccation with a 2mm central disc protrusion with slight central stenosis.
At C6-7, there is more moderate disc desiccation with a 3mm central disc protrusion with mild central stenosis but no direct spinal cord compression.
There is no evidence of nerve root canal stenosis or nerve root impingement at any cervical level. All of the facet joints are normal. The cervical cord is normal. There is no fracture or dislocation. There are no intradural or paraspinous masses.
My Cervical X-ray said:
Findings
AP, both obliques, open mouth, and lateral views of the cervical spine revealed very minimal hypertrophic uncovertebral joints at C5-6. On oblique view there is a suggestion of minimal osteophyte formation and foraminal impingement at C5-C6, especially on the left side. No fracture is seen.
Lumbar Xray - L3 Mild Osteophyte formation, indicates : Lumbar disc disease.
Medications: Atenolol 25 mg, Soma 350mg, Lexapro 10mg, Klonopin .25 (when needed), Cymbalta 30mg, neurontin 300mg 1x a day, either tyl 3 or reg vicodin for pain.
Neck Pain on left side, on the back of neck, in between shoulder blade on spine, headaches, left arm and leg pain, sometimes numbness or burning, muscle spasms. Depression and Anxiety.
butterflypain im 29 and my story is almost the same as yours. I hurt my neck at age 21 with mild pain off and on for the last 8 years....now I have spinal stenosis and feel my life is over before I got to age 30.
C2-3: Mild right facet joint degenerative changes and right neuroforaminal stenosis.
C3-4: Minimal diffuse discosteophyte bulge and mild central cananl stenosis.
C4-5: Mild disc height loss with central annular fissure. Small broad-based left paracentral disc protrusion. Moderate central canal stenosis-the disc protrusion abuts and mildly flattens the left ventral surface of the spinal canal.
C5-6: Disc desiccation with mild height loss.
Diffuse discosteophyte bulge and uncovertebral joint hypertrophy, moderate central canal stenosis-the discosteophyte bulge mildly flattens the ventral surface of the spinal cord. Severe neuroforaminal stenosis bilaterally, right greater than left.
I just had my first one and I don't know that side effects. can you help me with this.
Yes I just had a LESI today and I was wondering is there any side effects to the injection. If there is what. What are side effects if any.