Comment by kstrauser
4 days ago
I went to a doctor for something unrelated and ended up getting an MRI that happened to show my upper spine. The neurologist read it and determined that I have a Chiari I malformation[0]. I have no symptoms from this whatsoever. I never have. It's unlikely that I ever will. If it weren't for the MRI, I'd never have known.
Doctors use to think that the degree of it that I have meant I'd have problems with it. After all, people who came in with the symptoms and then had an MRI or CT scan tended to show that level of herniation. Thus, it was assumed, that level of herniation was considered a diagnostic indicator. And then MRIs became cheaper and more accessible, and patients had them for all sorts of other reasons — like I did. Doctors discovered that the degree of "malformation" I have is very common among asymptomatic adults. In fact, you're many times more likely to be perfect fine with it than to experience symptoms.
Well, huh. That doesn't sound like much of a malformation anymore. Or at least, by itself it doesn't mean anything, other than that perhaps you're more likely to have problems than otherwise. On its own? It's more of a normal variation.
This is well known for spine issues in general: MRI is super unspecific, and the older you get, the more interesting things you can find on the scans. Even if you're fully asymptomatic. So such findings are now better reframed as age-related changed rather than pathologies. The fact that every radiologist will highlight different things also doesn't help.
This is in fact one reason why you don't want an MRI if the outcome does not change what you do (i.e. sports related injuries or non specific low back pain). You will just nocebo yourself into thinking you have problems that are not real, because the belief in the answer donut is so strong.
That makes perfect sense to me.
One nit: this happened to me maybe 20 years ago. It wasn’t even an age-related change. I think it was more like a changing idea of the range of normal human anatomy.