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Is this what atrophy looks like?

Exit forum ID Forum Discussion Is this what atrophy looks like?

This topic contains 5 replies, has 3 voices, and was last updated by   Matthew Ellerbrock July 22, 2019 at 3:22 pm.

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  • #7617

    Matthew Ellerbrock

      So when reviewing a recent MRI this morning, I noticed an abnormally vast amount of white on the images below.
      Is this complete atrophy of erector tissue replaced by adipose at that level?
      Also it was interesting to note this 59 year old male has zero back pain but recently has had severe right lower leg pain and right foot numbness. After being treated unsuccessfully with a couple providers for a few non specific lower leg diagnosis, he came here.

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      #7620

      Matthew Ellerbrock

        Here is another view for the above patient as well. I think there is a limit on each post.

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        #7622

        William Brady, DC
        Participant

          You got it. That is severe atrophy with fatty infiltration replacement. It’s a clear change in the structure of the muscle. Research is massively inconsistent regarding importance of this finding. I think because, research simply compares the MRI finding to pain. Disregarding function and load.

          See attached file for a PDF of a review article on the topic.

          What is your diagnosis for the patient?

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          #7625

          Matthew Ellerbrock

            Thanks Bill.
            Dx with
            1. Severe DDD @ L5 S1
            2. Moderate to severe nerve entrapment @ L5 and S1 right nerve roots (NCV just confirmed)
            3. Grade 3 muscular adhesion various lumbar spine
            4. Muscular atrophy in the lower lumbar spine.

            He is currently on a holding pattern of a low dose Prednisone until he gets a lumbar fusion. He was hoping I would be able to help, however the role we played was determining the correct cause of the severe R leg symptoms and referral to a neurosurgeon. He had been told by a specialist that he needed a R knee replacement. (which he actually does but it wouldn’t have helped his current pain)

            #7626

            Doc Nina
            Participant

              Hi Matthew! What is the reason they are giving him prednisone?

              #7628

              Matthew Ellerbrock

                It’s to control the severe leg pain. It does work to control the severe leg pain, I assume it’s stopping the inflammation at the foramen and allowing space for the nerve to move.

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