Dr. Chitrangada Jitendra
Radiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have lower back pain in the morning and from recently, I cannot bend and I have weak legs and pain in the calves, hips, and hamstrings. I did some X-ray. Can you interpret it?
Hello,
Welcome to icliniq.com.
I have seen your reports (attachment removed to protect patient identity). Your X-rays indicate changes of spondylitis in the form of disc space reduction and osteophytes.
For the symptoms you have, I would recommend an MRI of the lumbar spine with whole spine screening and back strengthening exercises.
For more information consult a radiologist online.
Patient's Query
Hello doctor,
Thanks for the prompt reply. I appreciate that. I need some more help also. Please guide me. Is this AS? Could you tell me which L1 or L2 is affected most? What is the grade? What about sacroiliac joint? Can an MRI or something else add information for interpretation? If there is no cure, how severe is my case? In extreme cases, what would be the solution?
Extreme exercise or surgery usually? I like surgeries if it heals completely. Beside lower back pain, could this abnormality in spine and disk give me cold feet? Every time when I sit or stand still and turn to my foot sole or the entire foot and toes and now legs too before the knee turns red and cold within a fraction of a second. My rheumatologist ruled out after checking legs artery, pulse artery disease, and Raynaud phenomenon. Should I request thoracic and cervical imaging also as I have some neck pain and chest wall discomfort but Ido not know if technically it is possible?
Hello,
Welcome back to icliniq.com.
No, this is not ankylosing spondylosis as the sacroiliac joint space is preserved and vertebrae appear normal in characteristic. There is joint space reduction at L4-L5 and more at L5-S1 level indicating spondylosis.
MRI will help in evaluating the disc changes and any nerve compression which is causing your symptoms and over time if it is worsening or not. Also, this will help your consultant decide the necessary treatment that you would require - in terms of medication or in worse scenario surgery.
Your case is very early in terms of X-ray findings. However, MRI can pick up more subtle findings.
With whole spine screening that I recommended they would cover everything with a focused scan of the lumbar spine and also will be cost effective.
For more information consult a radiologist online.
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Radiology
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