Misdiagnosis of spinal AVM?

I am feeling very frustrated....after having back pain for a year due to a minor work injury (one of my clients hit me in the back), I began having pain that wrapped around my ribs in February. Up until then, I had severe back pain in my lumbar that eventually started going into my thoracic area. Eventually, pain started wrapping around my ribs on the right side. In the past few months, I've had headaches, debilitating pain at times, muscle spasms, weakness in my legs (not constant), tingling on my right side, and 1 episode of numbness and tingling in my left arm that went into my face.

After PT, injections, muscle relaxers, etc., an MRI was taken and my doctor found what he thought was a huge spinal AVM from T1-T7. After meeting with a neurosurgeon at the local "good" hospital in my city, he told me I had scoliosis and ordered another MRI with contrast and MRA to rule out the AVM. I didn't go back to him and went to a good hospital in Philadelphia. He scheduled a spinal angiogram just in case I did have an AVM. He concluded, as well as the radiologists who read my other MRI at my local hospital, that there was no evidence of an AVM. Therefore, he cancelled my angiogram and told me to go to pain management.

However, I have "flow void artifact" in my cerebral spinal fluid. Apparently, these flow voids or "artifact" in my CSF are what they thought originally was the "AVM" in the first MRI. My physiatrist, who originally found the "AVM" (and one of the few docs I actually believe is a good doctor), said this is just not normal. Although He is a well respected spine specialist in the area, and feels at this point that we should treat my pain. No one else seems to want to help us find out what it is. Has this happened to anyone else? Although the likelihood is less that it is an AVM, I don't know who to turn to to help find out what these artifacts are in my back!

Hi Amanda. It’s important to understand that flow voids in an MRI are normal wh.ere you have fluid in motion. That’s why they are called artifacts. If you have flow voids in an MRA or angiogram, I believe they may represent stenosis or high velocity fluid flow, and would just be referred to as flow voids. So,it’s understandable that flow void artifacts alone might not indicate the need for additional tests.However, your continued suffering does. I would keep looking for a doctor who is willing to do that spinal angio. I am not a doctor and this post merely represents my interpretation based on my own research of various medical imaging techniques. Good luck to you.

Hi Amanada

Insist on doing a spinal angiogram as it is the standard procedure for diagnosis of avm.