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Thread: Confused - - MRI doesn't show anything

  1. #1

    Unhappy Confused - - MRI doesn't show anything

    Background: I had a terrible car accident on March 21, which resulted in a broken pelvis and sacrum. I had surgery to place an illiosacral screw and pelvic plate 5 1/2 days after the accident. Now, almost 5 months later, I still have serious pain and trouble walking, plus I have neurogenic bowel and bladder, numbness in part of my perineal area, and reduced sensation in parts of the saddle area. My doctor sent me for an MRI of the lumbosacral area. He expected to find an overlooked spinal injury.
    The MRI looks almost completely normal. There is a slight bulge in the L5-S1, but nothing serious enough to cause what I have going on. Nerves don't look to be compressed. My doctor was surprised, as he really expected to find a lumbar injury.
    He is sending me back for an MRI of my brain, neck, and thoracic region to rule any of those areas out, but he didn't really seem to think that is the problem.
    One thing I wondered was whether or not it could be that there was damage done in the crash or when the aides rolled me on my side a day and a half after the accident (They hadn't put no roll orders on me yet. It was the most painful thing I can imagine, even on all the morphine I was on.) but that the orif removed the pressure, making it look fine.
    Anyway, I am confused and concerned. Does an MRI usually reveal the problem? How often is this stuff not apparent on imaging? How likely is it to be a brain, neck, or thoracic problem?
    I would really appreciate any input, as I am very confused and a little frightened.

  2. #2
    Senior Member
    Join Date
    Aug 2012
    Location
    Pennsylvania
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    1,813
    I am no genius on what you ask. I did just have both MRI and EEG. I am trying to be allowed to attempt to regain driver license. I have brain as well as incomplete spinal injury. Maybe bring up EEG.

  3. #3
    What you are describing sounds like cauda equina syndrome - visible cord injury does not always correlate to severity of symptoms. The initial injury in the accident, and/or insult to the nerves during surgery, can cause this. I am not a medical professional, but from what I have learned about the cord in my own diagnostic process, the symptoms you're experiencing are most suggestive of lumbar/sacral nerve root involvement. Following an accident as serious as yours, it makes sense to get MRIs of the full length of the cord (if only as baseline references), so the plan to obtain additional studies is sound - but do discuss cauda equina syndrome with your doctor, and don't hesitate to get a second opinion if you continue to have questions.

    Many members of the CareCure community have cauda equina syndrome, and it figured in my own differential diagnosis. MRI is a marvelous technology, but it doesn't always reveal the whole story - and sometimes another set of eyes is needed to appreciate what's going on. Each doctor brings a particular skill set and range of experience to the diagnostic process, so keep pressing for the answers you need.
    MS with cervical and thoracic cord lesions

  4. #4
    I agree. Sounds like CES (cauda equina syndrome). What type of doctor are you seeing? A neurosurgeon or neurologist would be best to get an accurate diagnosis. If you have it, you should also be referred to a physiatrist (a specialist in physical medicine and rehabilitation, PM&R).

    An EEG would not be indicated...it is a test of brain activity. Your problem is either in the cord or cauda equina (which are spinal root nerves). If electrodiagnostic tests are needed, an SSEP might be helpful in making the diagnosis, but mostly a physical exam combined with trauma history such as you have is usually sufficient to make the diagnosis.

    (KLD)

  5. #5
    As stated above, you have many of the red flags associated with CES. I'd follow the above recommendations.

  6. #6
    Thank you all for the information and support. My doctor's degree is in osteopathic medicine and specializes in physical medicine and rehabilitation. He is considered by many to be the best rehab doctor in my area. However, I do have an appointment with a neurologist in 2 weeks.
    I do wish a doctor would confirm a diagnosis, as my disability was denied because even though I am disabled at the moment, it is not officially expected to last at least a year. I have read enough to know that this probably isn't going to magically go away in the next 3 or 4 months. And it is quite difficult to pay bills when there is no income.
    A diagnosis would allow me to quit sweating about how to keep the roof over our heads and focus on rehab and adapting.
    I will certainly bring up CES. to my doctor, but I don't want to come across as if I am trying to self diagnose.
    It is frustrating to be in limbo! I appreciate you all reading and responding. It is just a confusing time for me right now.

  7. #7
    The neurologist will be your best bet. The surgeon who operated on you in March might be able to help, also. You could probably hold off on discussing CES with your current doctor, since (as SCI-Nurse says) a neurologist would be most likely to diagnose you correctly, and you are scheduled to see a neurologist very soon. I completely understand how frustrating it is not to have a definite diagnosis, and I hope you'll shortly be out of that limbo.
    MS with cervical and thoracic cord lesions

  8. #8
    Member
    Join Date
    May 2013
    Location
    California. Senior C7/T2 incomplete BSS
    Posts
    89
    EvaB, it took three MRI's to find my injury site. I had a spinal infarct with damage C7/T2. Because of my age they kept looking for A cerebral stroke. When testing showed no brain involvement they began imaging lower and found the damage. Maybe a more extensive scan would find the location. I can understand your frustration. A Neurologist will surely find an answer. Good luck. Keep us posted

  9. #9
    See what the MRI of thoracic and cervical spine show.
    CWO

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