X-ray or MRI scan in BKK? Problem with a lower back.

[Shurup]

For the past 2 months and a bit I was having pain in my lower back which extends to pretty much everywhere in the lower abdomen at times so looks like the nerve got pinched or something.

I didn't really do anything to hurt myself, I had some discomfort in the lower back after my last tech diving trip but during my last business trip (shortly after diving) a few months back, I was asked to try traying at a new hotel. Hotel was nice and the bed was very soft and that is where the problem started - I woke up in the morning with very sharp pain in my back and it was so bad like there was a hot iron in my spine, I couldn't bend, sit or do anything if my back was not completely straight. I managed to get my Advil out of my suitcase and popped a few pills and the pain subsided. Later on I got more meds, muscle relaxant anti inflammatory and something for the pain and the pain got down to a manageable level but it would come back each night until I requested to be moved to my regular hotel with has harder beds.

I now been at home for a bit over a month but the pain keeps bothering me and still if I don't get out of bed carefully if comes back as a wrecking ball.

What bothers me is I have a medical condition http://en.m.wikipedia.org/wiki/Langerhans_cell_histiocytosis

I have a lesion on my pelvis bone near the socket with left femur bone, it thankfully went into remission and that was nearly a decade ago, but I found out about it in the same fashion - I woke up one night from a sharp pain in my left leg, popped an Advil and went back to bed later but the pain was getting progressively worse by the day so I went to see the doc. The tumor was eating away my pelvic bone and at one point there wasn't much material left near the socket and it cracked.

I really hope I don't have the same thing in my back now. Need to do x-ray or MRI and need a doc which can read the scans properly.

[nev]

I just had a MRI scan on my lower back to check if a trapped nerve, I had it done here in Khonkaen at the university hospital Srinakarind, cost me 8000 baht and the doctor who went through the scan with me knew exactly what to look for.

Maybe the price was cheaper as I was already staying in hospital with a bladder control problem, but I thought the price was quiet reasonable

[Sheryl]

Would help to know where in Bangkok you live?

Finding a place that can do and read and Xray or MRI is easy (Xray = every hospital, MRI = most large ones and there is also a specialized stand-alone imaging center.

However it would be a rare doctor here who would have ever seen a case of LCH so if anything abnormal you may need to think about going back home (or wherever it was you were previously treated). Any radiologist should, however, be able to tell if there is an osetolytic lesion anywhere in the pelvis or lower spine, and an Xray would usually be sufficient for that.

If it is LCH there would usually also be some abnormalities on chest Xray and in the blood count. So a Chest Xray and complete blood count might also be wise in addition to Xray of lower spine and pelvis. Be sure the radiologist knows the prior history.

[Shurup]

1st - thanks for the replies.

I'm not in bkk so asking about bkk (anywhere in bkk) as I won't have anything really good to where I live up country near Korat.

So I will do a blood work and an x-ray then of the lower back and a chest, but I never ever in my life have had anything abnormal shown up on chest x-ray, even when I was dealing with LCH. By the way I didn't get treated for it in any way, it went away by itself after cracking my pelvic bone, and it was in Canada. I'll definitely go back if the x-ray show anything abnormal.

Really at this stage I want to rule out LCH, then I can deal with whatever it is giving me pain.

So any specialist that can read the x-rays properly will do.

I've been to Paolo Memorial Hospital many times for my yearly checkups, does this hospital count as a major hospital?

Will MRI show any pinched nerve or anything that x-ray wouldn't? Maybe better to do an MRI one time to see a whole picture? Or will the x-ray show that also?

Edited May 31, 2015 by Shurup

[Sheryl]

Start with an xray of the spine and pelvis. Paolo would be fine for this. Just make sure radiologist knows the history and that you want to rule out an osteolytic lesion.

If it is not a recurrence of LCH then it is likely either muscle/tendon issue or degenetative disk disease. Xray will be normal in the former instance. In the latter case spinal film will show some narrowing of the intervettebrsl space and possibly also some bone spurs though the latter seem to often be missed until the film is reviewed by a spine specialist. At that point an MRI may or may not be indicated and best to let a spinal specialist decide. Quite a bit of information can be gotten from just xray history anf physical exam.