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I have had Fibro for a long time. I also have MS, degenerative disc disease, various muscular/skeletal problems. I've never gotten a good explanation about these results from my rheumatologist and wondered if anyone here understands these findings. Thanks.
Reason for Exam
1. Adductor muscle tear; pain
2. Adductor muscle tear; pain
Powerscribe Read
HISTORY: Adductor muscle tear; pain, bilateral groin pain, left greater than right.
COMPARISON: None.
TECHNIQUE: Two examinations are submitted. MRI of the left hip and MRI of the left thigh without contrast.
FINDINGS:
The osseous alignment is normal without acute fracture or dislocation. Both femoral heads are properly located within the respective acetabula. No significant joint effusion is seen in either hip. There is mild degenerative change involving the hips, pubic symphysis and SI joints. Mild right gluteus minimus insertional tendinopathy is identified without evidence of tear or superimposed bursitis. Muscle signal intensity is normal, except for fatty atrophy of the
MRI
paraspinal musculature. Within the left femoral diaphysis, there is an approximate 1.0 x 1.0 x 2.3 cm T1 hypointensity/T2 hyperintensity, for example seen on series 4, image 14 as well as series 5, image 12. There appears to be a few internal areas of fat remaining in this area. On series 6, image 16 of the left hip exam, there may be a smaller, but similar area in the right femoral diaphysis which measures 5-6 mm in size. 4 mm T1 hypointensities in the right ilium on series 3, image 5 and series 5, image 9 and also in the left ilium on series 3, image 10 and series 5, image 11 on the left hip exam are also seen. On fluid sensitive sequences these areas do not obtain significant signal. There are degenerative changes in the visualized lumbar spine. Areas of bone marrow edema in the L4 and L5 vertebral bodies are thought to be degenerative in nature.
Uterus is absent. There is a small amount of free fluid in the pelvis, for example seen on series 4, images 15 and 16 on the left hip exam.
IMPRESSION:
1. No acute abnormality in the left hip or left thigh. Specifically, no evidence of adductor muscle tear.
2. 2.3 cm area of T2 hyperintensity in the left femur and to a lesser degree the right femur as above. There appears to be mild fat within this area and this may represent marrow infiltration, possibly from an island of red marrow, nonspecific. There are smaller areas of T1 hypointensities in the right ilium and left ilium, too small to characterize. Followup MRI in 3-6 months without and with contrast is recommended to determine stability. Bone scan may also be of benefit.
3. Mild right gluteus minimus insertional tendinopathy without evidence of tear or superimposed bursitis.
MRI
Reason for Exam
1. Adductor muscle tear; pain
2. Adductor muscle tear; pain
Powerscribe Read
HISTORY: Adductor muscle tear; pain, bilateral groin pain, left greater than right.
COMPARISON: None.
TECHNIQUE: Two examinations are submitted. MRI of the left hip and MRI of the left thigh without contrast.
FINDINGS:
The osseous alignment is normal without acute fracture or dislocation. Both femoral heads are properly located within the respective acetabula. No significant joint effusion is seen in either hip. There is mild degenerative change involving the hips, pubic symphysis and SI joints. Mild right gluteus minimus insertional tendinopathy is identified without evidence of tear or superimposed bursitis. Muscle signal intensity is normal, except for fatty atrophy of the
MRI
paraspinal musculature. Within the left femoral diaphysis, there is an approximate 1.0 x 1.0 x 2.3 cm T1 hypointensity/T2 hyperintensity, for example seen on series 4, image 14 as well as series 5, image 12. There appears to be a few internal areas of fat remaining in this area. On series 6, image 16 of the left hip exam, there may be a smaller, but similar area in the right femoral diaphysis which measures 5-6 mm in size. 4 mm T1 hypointensities in the right ilium on series 3, image 5 and series 5, image 9 and also in the left ilium on series 3, image 10 and series 5, image 11 on the left hip exam are also seen. On fluid sensitive sequences these areas do not obtain significant signal. There are degenerative changes in the visualized lumbar spine. Areas of bone marrow edema in the L4 and L5 vertebral bodies are thought to be degenerative in nature.
Uterus is absent. There is a small amount of free fluid in the pelvis, for example seen on series 4, images 15 and 16 on the left hip exam.
IMPRESSION:
1. No acute abnormality in the left hip or left thigh. Specifically, no evidence of adductor muscle tear.
2. 2.3 cm area of T2 hyperintensity in the left femur and to a lesser degree the right femur as above. There appears to be mild fat within this area and this may represent marrow infiltration, possibly from an island of red marrow, nonspecific. There are smaller areas of T1 hypointensities in the right ilium and left ilium, too small to characterize. Followup MRI in 3-6 months without and with contrast is recommended to determine stability. Bone scan may also be of benefit.
3. Mild right gluteus minimus insertional tendinopathy without evidence of tear or superimposed bursitis.
MRI
Basically, skimming it, and since I've had pelvic MRI and injuries, I'd say you've got some cranky soft tissues and they're concerned about the long-term viability of your pelvic structures and hips. I have serious issues ahead for me because of my scarring from my 2011 injury. I have nerve issues from my injury and I am essentially in the same place now, in my mid-forties, that my mom is at 70-plus---all because of the accident damage. (Minus osteoporosis concerns.)
If you aren't happy with the rheumatologist's explanation, ask for a direct consult with an orthopedist or some other specialist in pelvic issues. (Sports medicine doctors sometimes do well with groin pain, as it's considered "leg" injury.)
I can't interpret your results, but based on my experience having pelvic-spine issues? The specialists to check with are orthopedists, sports, neurologist, in my case. THat's all I can offer. My own experience.
Luck to you.
So sorry to hear about your accident. Nerve damage is so tricky.
I'm willing to bet the docs are concerned that if you encounter balance issues, or muscle weakness, it would be far too easy for you to break a hip, with the osteoporosis to boot. I hear that lecture. (Oy.)
Glad I could at least offer some time. At least your MRI showed something. My scarring's so bad that half my MRIs were inconclusive as to whether I even *had* a pelvis, LOL.
Has your doc offered any alternatives? Like supplements or so on? Worth asking if he hasn't. (Or she.)
Good luck---it's insane how multiple conditions turn life into such a circus. I have epilepsy, FM, chronic pain from injury, and PTSD. Some days I don't know why I'm even vertical!