Do radiologists take patient's age into account when reporting results to your Dr.?

[Own2Feet]

I am 52 and in pretty good shape. For two months, persistent pain on the right side of my neck has interfered with my workouts, turning my head while driving, and working at my desk. Finally, I gave up and went to my primary physician. After many questions, and physically turning my neck this way and that, he opined I had muscle spasms, likely stemming from osteoarthritis in the cervical vertebrae, and sent me for X-rays.

Dr. called me with the good news that the radiologist's report came back "normal." Then he sent me to the physical therapist. I had my first PT session yesterday.

After many, many questions and manipulations of my neck, shoulder and arm, she opined that I have muscle spasms, likely stemming from osteoarthritis of the cervical vertebrae. When I said my neck X-rays were normal, she said "Normal doesn't necessarily mean you have no wear and tear. Some wear and tear is normal as we age, and you have classic osteoarthritic symptoms."

I don't get it. If there is wear and tear, age-related or not, shouldn't the radiologist report that to the Dr., and let the Dr. decide whether it's "normal" for his patient?

 

[Rich_by_the_Bay]

Not all diseases show up on x-rays, and muscle spasms, sprains, strains and lots of other things that hurt may occur with no x-ray changes.

"Normal" changes with age, but even the signs of aging such as osteoarthritis need to be interpreted in the context of the symptoms, the radiologic manifestations of the diseases being considered, and the specifics of the patient at hand. Zillions of older people have arthritis on their x-rays with no symptoms at all. Others have severe pain and minimal x-ray changes.

There is just so much the radiologist can tell you other than the findings and hints as to what might cause those changes. These must be put in to clinical context by the ordering physician.

Not sure I answered your questions, but hope that helps.

 

[Own2Feet]

Rich, you raise some good points. After re-reading what I wrote, I realized I was assuming that osteoarthritic changes will show up on X-rays every time. I guess my real question is: Can I have osteoarthritis, that is bad enough to cause pain, without any degeneration showing up on X-rays? and that is more appropriate to an arthritis forum than this one....Thanks anyway; sometimes just the act of writing/posting helps me clarify things.

 

[haha]

Why don't you just ask your MD to send you the radiology report? The direct way is often the best way.

 

[Rich_by_the_Bay]

I guess my real question is: Can I have osteoarthritis, that is bad enough to cause pain, without any degeneration showing up on X-rays?.

Cervical spine? Unlikely but possible. But you certainly could have a slipped disc or any of several other conditions that might not show up. Of course, ask you doctor but just remember the x-ray is only one piece of the puzzle.

Hope whatever it is responds well to therapy.

 

[Nords]

For two months, persistent pain on the right side of my neck has interfered with my workouts, turning my head while driving, and working at my desk.

I understand the thought process-- the left side of your neck is just as old as the right, so if they're not detectably different then why should you have problems?

The PTs may feel better at confirming the physician's diagnosis, but they're rarely qualified to re-evaluate the doctor's opinion. I once spent three months in PT doing iliotibial band exercises when the original problem turned out to be a torn anterior cruciate ligament. But the ITB got stronger & more flexible while the knee's swelling/pain was going down, so the PT was pronounced a success. Yeah, but it didn't solve the problem.

It's also possible that your posture has changed in response to some muscle injury and is now contributing to the condition instead of allowing it to heal. I've had a lot of improvement from Jolie Bookspan's website with proper exercise form and by paying attention to my own posture. Scrolling through her index might find something that works for you:
The Fitness Fixer - blog index

 

[Meadbh]

I am 52 and in pretty good shape. For two months, persistent pain on the right side of my neck has interfered with my workouts, turning my head while driving, and working at my desk.

Is your right hand the dominant one? Do you do a lot of writing? Do you hold the phone to your right ear?

All these activities could contribute to muscle spasm on the right side of your neck. If you spend hours on the phone, get yourself a headset. It worked for me!