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diagnostic testing frequency & result interp variances?

wonder if-when you have an MRI done, if there woudl be a difference in the intepretation of the results with different radiologist. (or who ever types up the report)
it seems the doctors go off of the written report. What if the person looking at it misses something or misreads it. Is this possible? If a person was to take the IMAGES to someone else, would they be able to come up with info on it?
Also-how often should one have a MRI? if there has been no injury but still constant pain-how often should one be repeated?
Is an MRI enough? or should a CT scan be done as well, or nerve conductivity testing as well???
What are your thoughts-other than my spelling is horrible?


  • dilaurodilauro ConnecticutPosts: 9,859
    Whenever you have different eyes looking at the same item, the chances for different interpretations always exist.

    When it comes to spinal diagnostic test results, when there is conflicting analysis, you always need to get additional opinions to make sure there is consistency in the readings.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • To me, it's about making sure you have a highly skilled Dr. who will look at the films and make their own determination. They will certainly read the remarks by the radiologist, but they also are knowledgeable enough to determine what is going on.

    I only see a Board Certified Neurosurgeon (who is also Fellowship trained). They are the top of the top when it comes to the spinal cord, nerves, and all issues related. Board Certified Orthopedic surgeons are usually more trained in the lumbar area of the spine in addition to any other Orthopedic issues.

    A MRI should be enough to view any type of spinal issues and my Dr. will recommend if there isn't any new injury to only do it once a year.

    Keep in mind that pretty much starting at the age of 25....we all start to have degenerative disc changes in our spine and that is where a qualified Dr. will be able to see the difference between things that are a normal part of aging and then anything that is causing actual damage to where it needs immediate attention.

    If they see things on the MRI that are cause for concern along with looking at your medical history and doing a thorough physical exam to see if you are having any nerve related problems to where surgery may be on the horizon, this is when a nerve conduction study is done.

    Thankfully 85% of people with spine issues can be helped non-surgically. It may "seem" like the percentage is higher on boards like these or anywhere on the internet as people are going to come online when they are still hurting and having problems.

    What Dr. are you seeing now and what types of treatments are you doing? (Meds, injections, PT, etc?)

  • as in they won't pay for mor than 1 in a given time frame unless there is some extenuating circumstance that warrants. I've had at least 1 cervical every year for the last 4 years to track progression of deterioration and correlate with new symptoms. Lumbar, I was getting good results from blocks every 6 months so I went 2 years between MRI.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • ive had lower back pain for over 10 yrs with no insurance. so once i was finally insured-and preexisting condition time frame over, my family doc sent me for a mri. before the MRI, I had done chiro care, PT, meds. After MRI i was refered to a place called a pain clinic. my DX is w Degen. Disc disease; Lumbar Radioculopathy; lumbar spondylosis. My Pain doctor has done a medial branch block to Left side, Then radiofrequecy neourpathy to left side, one injection on both right and left-Lumbar Transforaminal Epidural Steroid Injection. My left side has not had any relief longer than a month. My right side-the injection i had a week ago is still helping! no pain on right side so far.
    I also seen a Rheumotologist, who jsut said my blood was normal. He did say that he believes I have Fibromyagia, and my Pain doctor agreed... my fam dr wants me to go back to a diff Rheumo who she likes better for further testing.
    I take Gabapentin 300 mg 3 xs a day; an antidepressant; tramadol & tizanidine as needed for pain; and an antiinflamitory every day.
    I dont feel so confident that the pain doctor is doing much good. all the work he did on my left side has not helped. I seem to remeber him doing the Radiofrequency Neupothy to my left side because he thought i was facet joint pain. my when i talked to him last week, he said my dx is Degen. Disc disease; Lumbar Radioculopathy. when they do the injections, he views my spine to do the injection. i dont knwo that he looked at my MRI, or just went off of the results. I know the Rheumo just read the results.
    My pain doc also said that fibro is making all my sypmtoms worse than another person might experience them. im not convinced i have fibro, i do have tender spots, and random pain in odd places that last for days, but im not super tired or anyting.
    I just want this NONSTOP deep ache, stiffness, restricted movement and everyting to go go go away. i hate taking heavy meds, i dont see why he dont give me a pain patch to put on the local area! i go back mondya for another injection of some sort.

    I wonder if I trust doctors-it seems as if they are just shooting in the wind trying to dx me. they are willing to inject me yet not willing to give me a darn pain patch to apply to area-idont get why. My dr says that my Fibro that he just recently dxed me wiht is why im in so much pain-that im just feeling extra pain from the fibro and that pain meds dont fix it. IS THIS TRUE?
    Do you feel like your docs are just guessing???
  • So you have asked your Dr. for a Lidocaine or Flector patch to put on the area and they refuse? This seems strange..I would mention either of those at your next appt. and see what they have to say. Those go directly over the painful areas.

    From what you write it sounds like you could have Fibro...So I'm not sure what further testing you are saying another Rheumy would do that you are looking for?

    And yes, those with Fibro can be much more sensitive to pain issues. I was diagnosed back in the mid 90's and the Flexeril I use is very helpful for those spasms. But most of all it's the daily exerciset (I walk every day) stretching/yoga, eating well, and acupuncture and massage that helps. As well as getting a good night's sleep as without this...pain levels can always seem much worse.

    I only think Drs. are guessing when they are with a patient that has some extremely unusual symptoms...Yours sound like it's both spine issues and Fibro.

    Are you able to exercise each day for at least 45 minutes? As well as I hope that you don't smoke..This has now been proven to cause more spine problems due to dehydration as well as they find those who smoke have a lower tolerance to pain.

    Again...it really stinks to have spine issues and many of us are going to have them for life so it's just about getting to a level of 5 on the pain scale and using every single modality we can to help with the pain from exercise, TENS unit, injections, acupuncture, massage, physical therapy, ice, heat, steroids, counseling, biofeedback, etc..

    You are actually on a pretty low dosage of the Gabapentin...It goes all the way up to 3600mg for therapeutic levels. Most people get relief in the 1600 to 2400 range though. So I would ask also to be using that med to it's full potential for nerve pain.

    I know it's hard to live with chronic pain...we all can empathize. This is why I continued counseling after my divorce to work through this issue and figure out healthy ways to live with the pain. And that is the operative word.."live" as it's still possible to have a great life even with this...Many of us are very blessed in that it's not terminal cancer.

    I certainly hope that your Dr. will be able to tweak some things for you but if you feel they aren't willing to provide the most comprehensive treatments for you then it's time to go elsewhere. Unfortunately there isn't a magic pill to take to take our pain all the way down. We have to see it as pieces to a puzzle.

    I wish you luck..
  • thanks for responding and the info. I do have a tens unit and need to remember to use it more often and yes i do smoke. (not good) i do stretch everyday-it feels wonderful.

    i will ask again monday, and if he says no again i will ask why. i cant imagin why he would say no. makes more sense to deliver relief directly to the area.I did not ask for the name of the pain patch. I will also ask if he thinks an increase in the gab would help. i thought it seemed like a high dose,but i know nothing of the meds.

    The Rhemo recommendation was that i guess he could have tested more things then he did? I have a family history of both RA & Lupus.

    Thank you for putting my pain into perpective-i am thankful that i do not have terminal cancer or some sort of disease that is fatal..
  • That makes sense that you would want to double check and rule out RA or Lupus as those would be treated with certain medications.

    And I truly do understand what it's like to have chronic pain and that we can really get down when our lives are changed so much. I just try to remind myself that I'm still alive and kicking and still want to do many things that bring joy into my life.

    This is where I have wonderful Drs. in that I have asked them what could I do to actually "injure" myself further, and then what is just going to cause me some extra pain. So I will go on that motorcycle ride with a friend (riding not driving it) because I love it so much, I still hike with my dog, and enjoy time with family and friends. Yes, I have had to give up some things that I really liked to do but replace them with other things.

    I really hope it goes well for you at the next appt....
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