Dr. Stefano Sinicropi, M.D.

Imaging tests give us an inside look at structures in the body, and oftentimes they tell us way more about an issue than a provider can surmise with a physical exam alone. The problem is that sometimes people assume that an imaging test will always provide them with a clear understanding of what’s going on in their spine. We can certainly learn more with these tests, but the spine is incredibly complex, and results can remain unclear or images can be misinterpreted. In today’s blog, we take a closer look at why it can be so challenging to get a correct diagnosis with a lumbar spinal MRI.

Common Misdiagnoses With Lumbar Spinal MRI

There’s a lot going on in your spine, which makes it difficult to pinpoint the exact cause for your discomfort. A subtle shift in disc position, a tiny compressed nerve or the formation of a small overgrowth in different sections of bone can all lead to symptoms but can be difficult to catch even on an imaging test. Let’s take a closer look at a variety of spinal issues and give a quick explanation as to why the issue may be overlooked or misdiagnosed with a spinal MRI:

• Herniated Disc – A herniated disc can be misclassified as a bulging disc if the imaging doesn’t clearly illustrate the changes in a disc nucleus.
• Disc Tears – Also known as annular tears, these fissures can be small and difficult to pinpoint even with the help of an MRI.
• Nerve Root Compression – It’s not uncommon for some nerve root compression to be seen on standard imaging tests, so providers may overlook it as the true cause of injury. Can sometimes be hard to see on a lumbar MRI.
• Modic Changes – Similarly, most people experience modic changes to their vertebral endplates as they age. These are asymptomatic changes for many, but for others they can cause symptoms, so it’s up to a provider to determine if these changes are the actual root cause of your discomfort.
• Facet Joint Arthritis – Again, arthritic changes are commonly seen in imaging tests for older adults, so the presence of these degenerative changes doesn’t necessarily mean that they are causing your pain. Facet joint arthritis seen on an imaging test can oftentimes be understated or overstated.
• Non-bony overgrowth – Some tissue changes can be difficult to spot with an MRI unless contrast dye is inserted, which isn’t standard with a run-of-the-mill lumbar MRI.

If you’ve undergone a spinal MRI and have struggled to find success with your course of treatment, consider having a second specialist take a closer look at your MRI results. It’s possible that they’ll catch something the other provider missed, or they may simply see things differently and attempt to manage the issue in a new way. They could also order another round of imaging to attempt to provide more clarity or hone in on a specific area of your spine. Don’t assume that you have a correct diagnosis simply because imaging tests were taken. Many spinal issues present with similar symptoms and may not be obvious on an imaging test, so be confident in your diagnosis but open to reevaluation if treatment isn’t yielding the anticipated results.

For more information about spinal imaging, or for help treating a specific spinal issue, connect with Dr. Sinicropi and the team at Midwest Spine & Brain Institute today at (651) 430-3800.

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