INTERPRETING A MRI REPORT OF THE LUMBAR SPINE. LATIN OR GREEK ANYONE?

I was given a sample MRI report as a medical student.  I felt like I was back in high school learning Latin and Greek.  A patient this week asked me to post about ways to understand and interpret an MRI report.

INTERPRETING A MRI REPORT OF THE LUMBAR SPINE.  LATIN OR GREEK ANYONE?

I go over hundreds of MRI reports and images during a typical month.  The biggest goal and challenge in the office is helping patients understand what the radiologist wrote. Here is a sample MRI report as an example.

So how do you decipher Latin or Greek in an MRI report?  Here are some 5 key points in understanding an MRI reports and conclusions.

  1. MRI’s and Imperfections.  MRI reports are written by radiologists trained to pick up imperfections in all of us.  The report typically will mention everything the radiologist observes in the MRI.  That does not mean that everything on the report is causing issues or symptoms.
  2. Understand basic terminology.  In order to understand the majority of the report, you need some basic introduction to terms.  Spinal stenosis, spondylolisthesis and degenerative disc diseases are all common terms you will see.  This is where Latin class begins. oOnce you get the hang of the language, you will be in good shape.
  3. Correlate the MRI with you.  As I said above, MRI’s pick up some normal aging findings.  Dr. Scott Boden published a well-known article that said a lot of people have findings on MRI but have no symptoms.  I go over the MRI with you in the office and focus on the portion of the report where you have clinical symptoms.  For instance, if you have left-sided sciatica, I will focus on left-sided narrowing of a nerve tunnel that correlates with you.  If the report shows narrowing on the right side, I will assure you to leave it alone if you have no symptoms.
  4. Follow up with surrounding findings.  I see a lot of renal cysts on MRI’s of the lumbar spine.  Many of these are not worrisome because they are simple cysts.  If there is any concern, either your primary care doctor or I will order a renal ultrasound to take a deeper look.
  5. Ask to see the images and the report.  The best way to go through a report is to see the images.  I will typically start at the top of the lumbar spine and work my way down the lumbar spine.  In that way, we don’t miss anything and you can check off the report along the way.  I will also use a model of the spine to show you the different views that appear on the MRI.

It is important to remember that a lot of the intimidating terms on an MRI report are simply descriptors of life.  While words like “moderate” and “severe” may be in the language, many people have no symptoms.  The key is to correlate the report with your chief complaint and educate you in the process.  What thoughts or comments do you have about MRI reports?  Any challenges you have had reading an MRI report in the office?  I would like to hear your comments.

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