Creator: Dr. Mubashir Razzaq Khan
Published: 2020-11-25T20:30:03-04:00

Patient's Query

Hello doctor,

I am a 37-year-old female. I had an MRI for my back. The report mentioned the following, and I was concerned about the comment on the bone marrow's low signal intensity. The doctor's assistant said there was nothing to worry about with the report, but the internet pointed things towards cancer.

Impression:

1. Small posterior disc bulge at L5-S1, with no canal stenosis and no neural foraminal narrowing. Disc desiccation at L3-S1.

2. Diffuse low signal intensity of the bone marrow relative to the disc spaces, which is nonspecific and may be related to chronic anemia or medication-related effect.

Can you please confirm if there is anything to worry about related to the second comment?

My CBC reports done a week back were as under:

WBC count 9.3 x10E9/L. (3.4 to 10.0 x10E9/L3).

RBC count 4.83 x10E12/L (4.00 to 5.20 x10E12/L).

Hemoglobin 12.4 g/dL (12.0 to 15.5 g/dL).

Hematocrit 38.5 % (36.0 to 46.0%).

MCV 80 fL (80 - 100 fL).

MCH 25.7 pg (26.0 to 34.0 pg).

MCHC 32.2 g/dL (31.0 to 36.0 g/dL).

Platelet count 401 x10E9/L (140 to 450 x10E9/L).

Neutrophil absolute count 5.51 x10E9/L (1.80 to 6.80 x10E9/L).

Lymphocyte absolute count 2.49 x10E9/L (1.00 to 3.40 x10E9/L).

Monocyte absolute count 0.75 x10E9/L (0.20 to 0.80 x10E9/L).

Eosinophil absolute count 0.44 x10E9/L (0.00 to 0.40 x10E9/L).

Basophil absolute count 0.05 x10E9/L (0.00 to 0.10 x10E9/L).

Imm Gran, Left Shift 0.05 x10E9/L.

I have no other history except that I had intense pain in my right thigh and low back. I have had a history of slip disc for the past ten years. The upper right thigh pain and the slight numbness was being evaluated for nerve compression.

Answered by Dr. Mubashir Razzaq Khan

Hello,

Welcome to icliniq.com.

Your symptoms and MRI (magnetic resonance imaging) results are more related to osteoporosis. Moreover, overweight also plays a role in the backbone. Get oral calcium preparations once daily and injectable vitamin D (once weekly for six weeks, then monthly once). Use a straight hard bed, vitamin B12 (preferably injectable), folate preparation, iron preparation (20 minutes before meals). For pain in the back, take NSAIDs (non-steroidal anti-inflammatory drugs) or opioid analgesics (if the pain is very severe).

Patient's Query

Thank you doctor,

The hematologist asks me to get blood smear morphology, Ferritin, Lactate dehydrogenase, Serum /plasma reticulocyte count. Does this mean they found something and are trying to see if there is any cancer? I am a bit worried and cannot do the test until I get back to my place. I need your help.

Also, everywhere on the internet, it said diffuse low intensity means cancer, leukemia, or metastatic cancer. Is that true as per your experience?

Answered by Dr. Mubashir Razzaq Khan

Hello,

Welcome back to icliniq.com.

Low intensity also means there is no bone in that area. It favors your symptoms to be osteoporosis, in which bone gets dissolves due to hormonal imbalance, calcium, and vitamin D deficiency. In my opinion, you should get tests for LDH (lactate dehydrogenase) and ESR (erythrocyte sedimentation rate) if you got to work up for some neoplastic process. Get the test results and get back to us if these are abnormal. No need to contact if the test results are normal.

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