Your MRI report describes what your spine looks like, not why you hurt. Disc degeneration, bulges and tears turn up in a huge share of people with no pain at all. A finding matters only when it matches your symptoms and your exam.
A radiology report is written by one doctor for another doctor. It is not written for you, and it can be scary to read. Here is what the words really mean.
Read this first: an abnormal scan is normal
This is the most important thing to know before you read any further. Studies that scan people with no pain at all find disc degeneration, bulges and tears in a huge share of them. The share climbs steadily with age. Findings like these are very common in people whose backs feel fine.
So a report that lists several scary-sounding findings does not tell you why you hurt. It tells you what your spine looks like. Those are different questions. The exam answers the second one. It matches what the scan shows to where your pain really is and what makes it worse.
The scan does not hurt. You do. The job is to work out which finding, if any, explains your symptoms.
Words about discs
Disc bulge vs herniation
The words do not mean the same thing, and the difference matters.
Annular tear
A tear in the outer wall of a disc, and why ‘tear’ sounds worse than it is.
Disc desiccation
The disc has dried out. Almost everyone past thirty has some.
Degenerative disc disease
Not really a disease, despite the name.
Words about narrowing
Foraminal narrowing
The exit hole for a nerve is tighter than it was.
What ‘foraminal’ means
And how to pronounce it.
Spinal canal stenosis
Narrowing of the main canal.
Mild, moderate, severe
What the grades really mean.
Words about joints and bone
Facet arthropathy
Arthritis in the small spinal joints.
Modic changes
Signal changes in the bone next to a disc.
Spondylosis and spondylolisthesis
Two similar words, two different things.
Schmorl’s node
A disc pressing into the bone above or below.
Reading the levels
L4-L5, L5-S1 and the rest
How spinal levels are named and what each one supplies.
Vertebrogenic pain
Pain coming from the vertebral endplate itself.
Bring your scan to us
If you have a report you do not understand, bring it in. Bring it on a disc, through a portal login, or as a paper copy. We read the scan you already have rather than order another one. Call us or request an appointment.
Sources
- Brinjikji W et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American journal of neuroradiology, 2015. PubMed 25430861
- Fardon DF et al. Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. The spine journal : official journal of the North American Spine Society, 2014. PubMed 24768732
- Bezuglov E et al. Asymptomatic Degenerative Changes in the Lumbar Spine Among Professional Soccer Players. Spine, 2021. PubMed 33347092
- Banerjee A et al. The Prevalence of Degenerative Cervical Myelopathy-Related Pathologies on Magnetic Resonance Imaging in Healthy/Asymptomatic Individuals: A Meta-Analysis of Published Studies and Comparison to a Symptomatic Cohort. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 2022. PubMed 35255357
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Read this before the individual terms
An MRI report is written for another clinician, not for you, and the vocabulary is alarming in a way the findings usually are not. Degenerative change is close to universal past middle age: disc desiccation, bulging, facet arthropathy and foraminal narrowing all appear routinely in scans of people with no pain whatsoever, and the proportion rises steadily with age.
That is the single most important thing to understand before reading any individual term. A finding on a report is not a diagnosis until someone has matched it to your symptoms and your examination. Where the two agree, the report is genuinely informative. Where they disagree, the examination decides, and the finding is incidental.
What to do with your report
Bring the images as well as the text, on a disc or through a portal. The report is one radiologist’s reading of the study; the study itself is what a treating clinician needs, together with where your symptoms actually are and what the examination reproduces. We will go through it with you rather than leaving you to decode it.