Here is My Question:
How often, if at all, should a follow up spinal MRI be performed if a spinal lesion has already been found? I've had no new visible brain lesions for a few years but don't know the status of my spine.
You will likely receive a different answer to your question depending on who you ask. In my mind, the organizing principle behind when and what to image after the diagnosis has been made is to monitor the effectiveness of the therapeutic being used.
Approximately 90% of MS lesions on the brain scan are clinically silent with no perceived associated symptom which you'd be aware of. Quite the opposite is true with the spinal cord. When a new lesion established itself in the cord, symptoms invariable arise that you perceive and the neurologist can confirm on your exam.
If the purpose of cord imaging is to look for disease activity, I would rely on the symptoms and neurologic exam first before jumping in the loud clanking machine.
A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente
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