1st time visit w/Neurologist to review MRI

[prov2121]

Hi,

This is my first post and I hope I can get some insight prior to an appointment I have tomorrow (2/21/07) with a Neurologist. I've had pain in my lower back, right hip and right leg for the last 2 years and it's been progressively worse the last few months. I am a 40 year old female and excersice regularly. I had a MR Spine Lumbar w/o contrast done on 2/14/07 and the results were:

The lumbar vertebrae are normal in height. No subluxation is identified. There is moderate narrowing and desiccaton of the L5-S1 intervertebral disk. The remainder of the lumbar disks has normal height and hydration. The spinal cord terminates posterior to the upper aspect of L2. No disk bulge or protrusion is identified at the L1-L2,L2-L3,L3-L4, or L4-L5 levels. The thecal sac and neural foramina are patent at each of these levels. L5-S1: There is a small broad-based posterior disk bulge. This does not significantly contour the thecal sac or neural foramina. Mild facet hypertrophy is present. There is mild narrowing of both neural foramina, worse on the left.

Impression: Degenerative disk disease and mild facet spondylosis at the L5-S1 level, with mild narrowing of both neural foramina, worse on the left.
No disk protrusion or spinal stenosis.

I wanted to find out what to expect from my visit tomorrow or what questions I should ask of the doctor. All of the pain so far has been in my right leg, but the results show the left side worse...does this make sense? The pain actually goes all the way down my leg and into side of foot.

I'm not sure if I can expect a response with such little notice....any help would be appreciated though. Thanks!!!

[Dr. Joshua]

You are right that there's a discrepancy - the MRI finding is worse on the left, your symptoms are on the right. Whether the right sided foraminal narrowing due to facet hypertrophy is causing your symptoms, is the main question. This requires thorough history, physical examination and experience in looking at lumbar spine MRI and interpreting the finding in relation to the clinical picture. An experienced neurosurgeon/ spinal surgeon should be consulted if possible.

[prov2121]

Thanks for your reply. My appointment is with Dr. Kevin Sullivan, M.D., at the Medford (Oregon) Neurological & Spine Clinic. After some research, it appears he has been in this field for about 33 years, so I'm hoping that his experience will lead to some relief of my right leg pain.

Are there any questions you can suggest that I should ask Dr. Sullivan when I see him this afternoon?

Thanks again for answering my post. I really appreciate it!

[Dr. Joshua]

I'm glad you're seeing an experienced doctor and I'm sure your doctor will be able to help you, keep us posted here

[prov2121]

I just returned from the Neurologist office. After reviewing my MRI and a physical exam, the doctor thinks I have tendonitis in the hip area. He said to take 2 Aleve tablets a day and don't do any excercises with the leg for 2 weeks. I hope his diagnosis is correct, because I'm dealing with some pretty painful symptoms.

Thanks again for your input!

[Dr. Joshua]

Thanks for the update. Follow your doctor's orders and let's see what the situation is like in two weeks. Is a follow-up scheduled?

[prov2121]

He didn't feel a follow-up appointment was necessary. If I'm still in pain in 2 weeks, then I can maybe try some pain management (shot) or physical therapy.

Question for you...can the inflammation in my hip area cause an elevated C-Reactive Protein lab result? I've had the blood test done twice in the past and the results were 5.1 and then 4.7.

Thanks!