MRI read as "mild degenerative changes at T7-8 possibly consistent with old hyperflexion injury" No known injury.
STIR image attached.
Any ideas?
DDD, modic changes.
Cat and camel exercises.
NSAID vs Ultram depending on risk factors.
No useful procedure or surgery.
Any markers of infection or malignancy? ESR/CRP/Procalcitonin/LDH/Alk Phos?
It's rather oddly symmetric and his other discs look rather good.
I would be concerned for infection/malignancy/etc due to the insidious nature of it.
This plus trial of manual manipulation.
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I wasn't planning any injections as I couldn't see how they would be of any value. Of note, I'll bet I'm the ONLY guy in town who wouldn't tee her up for a series of thoracic ESI.
Taus - I like the manipulation idea. Are you personally doing that in your practice?
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Call his PT - he may have already had a trial of thoracic HVLA.I wasn't planning any injections as I couldn't see how they would be of any value. Of note, I'll bet I'm the ONLY guy in town who wouldn't tee her up for a series of thoracic ESI.
Taus - I like the manipulation idea. Are you personally doing that in your practice?
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Did you just prescribe yoga?DDD, modic changes.
Cat and camel exercises.
NSAID vs Ultram depending on risk factors.
No useful procedure or surgery.
Did you just prescribe yoga?
Combining exercise with chicks in yoga pants is not a bad combo, truth be told.Only for myself.
What are you treating with an epidural?Worth trying a few injections. What you got to lose? Start with an epidural
What are you treating with an epidural?
What are you treating with an epidural?
This is why interventional pain reimbursement keeps getting slashed, needles are not always the answerDepends how you look at it. Steroids act as a local pain reliever as well. I mean, you put steroids in places like shoulders for chronic tendinopathy? Most people do, despite not an inflammatory process. Why? because shoot, it's worth trying. Some people respond. But hey, feel free to throw them on opiates, if you feel that's the more benign option.
Depends how you look at it. Steroids act as a local pain reliever as well. I mean, you put steroids in places like shoulders for chronic tendinopathy? Most people do, despite not an inflammatory process. Why? because shoot, it's worth trying. Some people respond. But hey, feel free to throw them on opiates, if you feel that's the more benign option.
Both appear equally stupid based on education, experience, and training.
Got any studies backing you up.
BTW, like your username. license to kill.
Had a patient like that with a very similar thoracic MRI with several levels showing strange anterior modic changes. The radiologist of course hedged and said cancer could not be ruled out if there is a high clinical index of suspicion. This sent me on a while goose chase getting inflammatory markers and an MRI w/w/o. Everything turned out unremarkable with modic changes being the final diagnosis. Crazy how bad some of these vets spines can look. I tried an epidural...don't shoot me
Just did it two weeks ago...haven't seen him back yet but we'll seeDid it do anything?
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