Lower back pain. Abnormal L4 and L5 discs. MRI shows dark spot on spine. What could this be?
Patient: For the last several months, I have been having lower dack pain . I went to the doctor and he sceduled me to have an MRI . He told me my L4 and L5 disc were abnormal. He sent me to a neuro specialist, which when he read the MRI, He started I had a dark spot on my spine near the affected disc.. I now have to take a bone scan and I an extemely anxious about what this could be. What do you think? Doctor: Hi and thanks fort the question, the dark spot could indicate a variety of abnormalities. These could range from artifacts, things that do not really exist to tumours. Itis therefore interesting to do an ESR frist. A very high ESR or erythrocyte sedimentation rate could suggest further investigations for spinal TB. Then blood calcium levels, alkaline phosphatase. Elevated values for these enzymes indicate a bone tumour.  An abdominal ultrasound and CT scan and a chest X ray could be important in ruling out any existent or spread tumour. I suggest a consultation with an internist first or a neurosurgeon for further investigations, Thanks and best regards, Luchuo, MD.