What Does My X Ray Report Suggest?

Posted on Fri, 22 Aug 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 22 Aug 2014 Answered on

Fri, 12 Sep 2014 Last reviewed on

Question : the attached xray is from about a month ago.The doc said i needed a ct scan to see what this was.The thought was could be anything.I had the xray done because of pain i experienced after some recent workouts and the doc thought i may have altered my lordotic curve with workout.While awaiting ct scan, the pain got a bit higher to about my lower ribs (but on back).I have been told to get mri, now and await same.I am starting to freak out about something spreading and cannot talk to my doc until monday. I don't expect a diagnosis but perhaps some guidance on what I should be looking for.

Answered by Dr. Vivek Chail (1 hour later)

Brief Answer:
I wish the X Rays were repeated before CT or MRI

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in details.
Being a radiologist myself, I wish to have another set of X rays in AP (frontal) and sideways (lateral) projection before confirming should you require a CT or MRI scan.

Having said that, a pain in the region of lower ribs may not exactly be due to a problem in the tail bone area. The assessment of pain in this portion of the body requires an ultrasound scan to see if your abdominal organs are normal. My objective is to discuss various possibilities of your pain and guide you through the simplest to advanced imaging investigations with minimum hardships.

The above is what I would like to do had you been a patient of mine. However your doctor suggesting MRI is very much acceptable if they feel a detailed examination is essential considering your symptoms.

In my experience you may relax and take your workouts a bit easy and not stress yourself physically to the point of discomfort.

Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (2 minutes later)

I can ask my doc, but she has prescribed MRI. I will not hear from her office until MOnday, at earliest. I can ask her to do xray, but suspect that she will wish to proceed with the MRI. I am just wondering what I should be worried about in the interim. I sense that i have a muscle strain caused by working out that has maybe led to a straightening of the lordotic curve, but I also worry that I hvae some spine tumor or something like that. I know that you can tell little from this xray, but thought I owuld ask .

Answered by Dr. Vivek Chail (32 minutes later)

Brief Answer:
Please find details in answer given below

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

Yes I agree that your doctor would always wish for a MRI scan to get a definitive diagnosis.

However the X ray shows a suspicious area in the tail bone which is the terminal portion of spine. It is clear that I am not expecting any tumor of the spinal cord which ends at a much higher level. If there is anything that keeps me guessing, it is the tail bone region and it is a completely bone area and therefore you were asked to get CT scan earlier.

With an MRI your doctor probably wants to have a look at the discs and nerves in the lower back and the tail bone region. Compression of nerves by degenerating disc disease can cause severe pain.

As per my suggeestion, a repeat of the X ray lumbosacral spine with coccyx (AP and Lateral Views) can give a road map and give little more detail on the tail bone region and also throw light on any muscle spasm by visualization of lordotic curve.

This can be followed by a more focused MRI scan if necessary.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (20 minutes later)

Thanks so much. I dont follow wha you mean when you write you are not wxpecting any tunor of spinal cord which ends at much higher level. I also failed to note that when i first noticed some pain in my very low back it was more discomfort but it also felt like my tail bone or lower spine was pushing out. As an exmple i feel my tailbone and or lower spine now pressing against my seat in car etc. This is why my doc thought the curve of back may have changed with my exercise which includes some work on that part of body. Now though it seems my whole back just feels out of whack and sleep is very difficult. Last few nights i awake with a weird tingling sensation and feel like i have to stay awake to avoid some catastrophe. t

Answered by Dr. Vivek Chail (1 hour later)

Brief Answer:
Please find clarifications below

Detailed Answer:
Hi XXXX,
You are welcome and may I clarify points raised by you.

The spinal cord is a soft cord like structure which continues downwards from the brain stem and is an important part of the nervous system. The nerves to the back arise from the lower portion of spinal cord. Commonly pain occurs due to discs causing pressure on the spinal cord or nerves arising from it. Rarely a tumor in the spinal cord itself can cause back symptoms. But as the spinal cord ends much above the tail bone, I would not connect these two things together. I meant that a tumor in spinal cord will not be seen in the tail bone region.

Tail bone tumors mainly arise from bone and may have soft tissue component. Usually tail bone is injured due to traumatic injury and the pain continues for a long time.

The way you have mentioned your problems, checking any nerve pressure related problems and muscle spasm is important.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar