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Radiology/Really Confusing Interpretations on 2 Lumbar MRIs


Neurosurgeon looked at February MRI ordered by another doctor and told me there's a free fragmented disc herniation at L3-L4 and also multiple level stenosis. He ordered a new MRI (August), but never mentioned "fragment" again.

A chiro/spine researcher, who has been published in Spine Journal, said there's actually a BILATERAL herniation at L4-L4. He said fragment issue was too close to call for certain.

Radiologist #1 did not mention fragment or herniation at
L3-L4. Described "wide disc bulge with moderate posterior facet and ligamentous hypertrophy."

Radiologist #2 did not mention fragment or herniation at L3-L4. Described "wide large wide disc bulge and moderate posterior and ligamentous hypertrophy causing moderate to severe spinal canal stenosis."

MRI #2 is available in my dropbox. I'm having recent bilateral calf cramping every day and don't understand why that would be coming from L3-L4 or L4-L5 (moderate wide disc bulge).

Also have many years of pain in quad muscles and am not clear on how that is caused by stenosis or herniated disc inasmuch as most explanations I've read just talk about sciatic nerve pain or general "leg pain," without correlating the pain to specific leg muscles/vertebra combinations.

I'm curious -- if there's a fragment at L3-L4, why wouldn't either radiologist mention it? Why wouldn't a radiologist use the term "herniation?" And, finally, how could a bilateral herniation be described simply as "a herniation" (unless it wasn't seen)? These folks don't seem to be on the same page and it's quite concerning to this patient.

Seems like there is a bit of discrepancy among the providers.  I can't really comment without looking at the images.  You said you have it in your drop box.  Could you provide me with a link so I can download it and review?

The use of the word heniation vs protrusion vs extrusion varies among providers.  but lets look at the images.


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Michael K.


Almost any kind of questions regarding any types of radiology exams, procedures, meaning of radiology reports etc...


12 year experience in the field of radiology

American Society of Neuroradiology, Senior Member Society of Pediatric Radiology, Active Member

Radiology Seminars in pediatric neurology American Journal of Roentgenology American Journal of Neuroradiology

Board Certified in Diagnostic Radiology Additional Certificate of Qualification in Neuroradiology

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