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Avatar universal

MRI help

I have seen many many Drs over the last 5 years.  Every Dr has different ev34 changing opinions. Lupus, RA, MCTD Polymyositis, inflammatory arthritis... I could go on.  I have many positive ANA tests homogenious.But, I was compiling my test results for my disability application and reread my MRI W/wo contrast from 4 years ag . Now I am more educated than when this began.  It is causing me to question whether or not I have MS either in addition or instead.  Plus I will add that I just found out a have a cousin with MS.
I don't want to list all my symptoms, so these are concerning and the drs just kind of ignore them. I have been falling down for the last 3 years. It is my right foot dropping and dragging or catching steps etc. Extreme braion fog with memory issues that have worsened.  Burning electrical pain, muscle weakness and swelling, tendon sheath swelling in my feet and ankles. I explain that it feels as though my joints are loose and move, pop and very painfu . Over the last 5 years this has gone from my hands and feet to my hips, shoulders and this last year my neck and spine seem unstable and painful.
  
So, I would like some advice on this MRI of 4 years ago that I feel may be important.  

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Scattered punctate foci of increased signal intensity best seen on FLAIR sequence in the subcortical and deep white matter tracts bilaterally.  They are non specific.  They do not enhance and do not cause mass effect.  They can be seen in multiple etiologies including small vessel ischemic changes, diabetes, hypertension, collagen vascular disease, vasculitis, migrane headaches and demyelination to name several potential etiologies.  Note is made they do not have the typical appearance and/or distribution of demyelination.

Cortical sulci and ventricules are within normal limits.

The basilar cisterns are patent.

Flow voids are identified in the distal vertebral arteries, the basilar artery and the bilateral internal carotid arteries.
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I am seeing a new rheumatologist this next week and I would like some advice regarding this repor . My past Rheumy said it was normal.  I have never been referred to a nuero!ogist.  Any help in understanding the MRI and if this may be important enough to follow through and push for a nuero evaluation... Would be helpful.

Thank you so much for your help!

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Avatar universal
Thank you so much.  I understand that 70% of people with illnesses may fit into a fairly clear category based on blood work. But the other 30% doesn't fit in the box.  Just because it doesn't fit into the box they build, doesn't mean I don't have...  something.  

Anyway thank you for reminding me of this.
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Avatar universal
Thank you very much!
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Avatar universal
No not yet. But I am seriously considering it now.  My new rheumy did the Avise test.  My ANA is 320 but everything else was negative.  I still have all my MRI's and Xrays that show joint effusion.  But he said that the radiologists were probably wrong??  Basically every dr I have seen is wrong.  Maybe they are but, he suggested I see a psychiatrist and when I had a tear fall down my cheek, he said see and pointed to his head.  It is not in my head.  I have imaging that shows damage.  So now he says I need a full body bone scan and an MRI of my right hip.  He didn't really trust the Ortho and the xrays.

I know that most specialists like to think they know everything.  I agree it may not be what my prior drs diagnosed.  But I am not crazy.  I am not sure about paying for these tests (deductible not met).  I want the answers, but I cant afford to pay for more tests that don't seem to make sense.
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1831849 tn?1383228392
Welcome to our group.

From what you quote, it does not seem like the radiologist thinks your findings are due to demyelination.  Demyelination is mentioned at a very long list of possible causes. As immi said, MS is a demyelinating disease. No demyelination means no MS.

That said, Alex brings up a very important point. MS is a clinical diagnosis. MRI, blood tests, LPs all serve to confirm clinical findings. Have any of the doctors you've seen been neurologists that specialize in MS?

Kyle
Helpful - 0
667078 tn?1316000935
MS has the same symptoms as many illnesses. The quickest way to tell if you need to see a neurologist, which can take months and more money, is to have your GP do a neurological exam. This is reflexes and such. They can tell by this simple exam if you have neurological problems and where in the central nervous system they are. My GP found my MS and sent me to a neurologist. I had MS before MRIs were invented in 1965. They did neurological exams my whole growing up and knew I had damage to my brain stem. That is where my MS damage is. MRIs are not as accurate as the simple neurological exam. If it normal then you do not need a neurologist.

Alex
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5112396 tn?1378017983
Your MRI results point away, rather than towards, MS. The pertinent sections

"and demyelination to name several potential etiologies.  Note is made they do not have the typical appearance and/or distribution of demyelination."

MS is a demyelinating disease. The radiologist has basically thrown the kitchen sink at the potential causes of the findings. Basically, the foci didn't point to anything in particular. This is where the importance of the exam comes in. It seems seeing a new rheumatologist is appropriate as many things that you mention are not experienced, or only experienced secondarily in MS (swelling, joint pain, etc.)
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