MRI Reports: Addressing Concerns in Throat and Neck Symptoms

MRI Report Issues

Hello Doctor, I have been experiencing a sensation of a foreign body and sharp pain in my oral and pharyngeal walls, as well as a similar sensation and pain in the mucosa next to the left base of my tongue.
Additionally, I have had inflammatory symptoms with intermittent pain for over three months.
Due to my concerns, I visited an ENT specialist and paid for an MRI with contrast.
A few days ago, when I reviewed the report with the doctor, he immediately asked if the examination was due to previous dizziness.
I clarified that the dizziness had resolved (and I had previously paid for an MRI of the brain which showed no abnormalities).
This examination was focused on the oral and pharyngeal walls and the deep throat, where I have been feeling a persistent sensation of a foreign body.
During my last visit, I had already informed the ENT specialist about my concerns regarding the sensation of a foreign body in the pharyngeal walls and the base of the throat.
On that day, the doctor said the report showed no issues.
I also inquired about a lymph node in my neck, and the doctor confirmed that the nasopharynx was fine.
However, after returning home, I began to feel uncertain, wondering if the doctor misunderstood that I was experiencing dizziness in May, which led to the examination being ordered, possibly fearing nasopharyngeal cancer as the cause.
However, my intention for this examination was to check for any abnormalities in the base of the oral cavity, the lower pharyngeal walls, the tongue, and the lower neck.
I am concerned that the examination may not have been thorough due to a lack of clear communication regarding the areas of concern.
Should I seek medical attention again and pay for another examination? I have attached the report from today for your review.
Could you please help me determine if the areas of the base of the oral cavity, lower pharynx, base of the tongue, and lower neck were adequately examined? Or was it that the report indicated no issues in the oral and neck base, which makes me worry that the examination may not have been conducted in the right areas? I sincerely appreciate your assistance, as the cost of a self-paid examination is quite burdensome.
😭 Could you please clarify if the MRI of the head and neck would typically cover the areas I mentioned, even if the examination order did not explicitly state them? I am genuinely worried that the examination may not have been thorough.
I apologize for the disturbance, but my symptoms have been quite uncomfortable and distressing, leading to my concerns about potential underlying issues.
Thank you for your response.
After receiving the contrast agent, I have experienced mild swelling and pain in the veins on the back of my hand and wrist, and I have already consulted a dermatologist who prescribed antibiotics.
However, it has been six days, and there has been no improvement.
What should I do now? Thank you.
If another examination is necessary, will a short-term re-injection of the contrast agent have any effects on my kidneys or body?

Miss Lin, 40~49 year old female. Ask Date: 2021/08/25

Dr. Wang Yifen reply Radiology

Hello, the imaging report you uploaded refers to the examination area of the head and neck, while the uploaded images focus on the area below the neck, specifically the thyroid gland.
The MRI of the head and neck encompasses the nasopharynx to the area near the cervical thyroid.
The oral cavity you mentioned is included within the scope of the head and neck MRI.
The report indicates: 1.
Bilateral neck shows nonspecific lymphadenopathy, 2.
Enlargement of the right palatine tonsil, please correlate with clinical findings, 3.
History of left tonsillectomy.
MRI has limitations as an imaging tool for tonsilloliths (calcifications) or superficial mucosal lesions (such as those caused by colds or other inflammatory conditions).
If your symptoms do not improve with treatment, it is recommended to consult an otolaryngologist for a thorough evaluation by a specialist, including a physical examination to assess potential causes.
Whether a repeat MRI is necessary should be determined by a physician's clinical assessment.
Please take this into consideration, and I wish you good health.

Reply Date: 2021/08/25

More Info

Understanding MRI reports, especially in relation to symptoms in the throat and neck, can be quite challenging and often raises concerns for patients. Based on your description, it seems you have been experiencing persistent sensations of foreign body presence and pain in your throat and tongue area, alongside inflammation for over three months. You sought an MRI to investigate these symptoms, and while the report indicated no abnormalities, your concerns remain.

Firstly, it's important to clarify that MRI scans of the head and neck are generally comprehensive and can visualize various structures, including soft tissues, muscles, and lymph nodes. If the MRI was specifically ordered to evaluate the oral cavity, pharynx, and surrounding areas, it should have adequately assessed those regions. However, the interpretation of the MRI results is crucial. If the report did not explicitly mention the areas of concern you have, it might lead to uncertainty about whether those areas were thoroughly examined.

From your account, it appears there may have been a miscommunication regarding the focus of the MRI. If the doctor primarily associated your symptoms with previous dizziness rather than your current throat issues, it could have influenced the interpretation of the scan. It’s essential to ensure that the radiologist and the interpreting physician are fully aware of your symptoms and the specific areas of concern you wish to investigate.

Regarding your symptoms, persistent sensations of a foreign body in the throat can arise from various causes, including inflammation, allergies, gastroesophageal reflux disease (GERD), or even psychological factors such as anxiety. If the MRI did not reveal any structural abnormalities, it may be beneficial to explore these other potential causes.
In terms of your follow-up care, if you continue to experience discomfort and your symptoms are affecting your quality of life, it may be worthwhile to seek a second opinion or consult with a specialist in otolaryngology (ear, nose, and throat specialist) who can provide a more focused examination. They may recommend additional tests, such as a laryngoscopy, which allows direct visualization of the throat and can help identify any issues that an MRI might not reveal.

As for your concerns about the contrast agent used during the MRI, it is generally safe for most patients. However, if you are experiencing swelling and pain at the injection site, it’s advisable to follow up with your healthcare provider. They may recommend symptomatic treatment, such as ice application or anti-inflammatory medications, to alleviate the discomfort. If the swelling persists or worsens, further evaluation may be necessary to rule out any allergic reactions or complications.

In conclusion, while your MRI report may not have indicated any abnormalities, your ongoing symptoms warrant further investigation. It’s crucial to communicate openly with your healthcare providers about your concerns and symptoms to ensure that you receive comprehensive care. If necessary, don’t hesitate to seek additional imaging or evaluations to address your symptoms adequately. Your health and peace of mind are paramount, and pursuing clarity on your condition is a reasonable and proactive approach.

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