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hey guys..i was reading master the boards and it said that in spinal stenosis we diagnose with MRI. Now my question to you guys is this: If the question gives a case of spinal stenosis and they ask you the BEST INITIAL: would it be MRI or ankle brachial blood pressure ratio. From what I thought, i thought we do the ankle brachial blood pressure ratio and peripheral pulse as the initial step because if that is normal or >1 we exclude peripheral vascular disease but not sure if that is our initial step, or MRI. Would appreciate any input. Thanks
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well it depends on clinical presentation and PE
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hey masterusmle ,,,
Why would u do ankle brachial blood pressure ratio in a case of spinal stenosis??
Spinal stenosis is caused by tumor , abscess , disc herniation or prolapse , osteopetrosis, spinal degeneration : due to which there is compression of the spinal nerves causing symptons depending on the nerves involved ... MRI is theeee Invetigation for it..
ABP ratio is to relate UL vs LL pressures n a ratio is derived which if more than .9 is acceptable... so this deals with vessel blockade or thickening n not with spinal nerve..
As per me u would not do ABP ratio in a case of Spinal stenosis when they ask u the best initial.
please correct me if i m wrong
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thanks vinnie..i think you are right..i just figured because spinal stenosis presented with pain on walking in the leg that you would want to rule out peripheral artery disease before you do an expensive radiologic test like MRI. I know that the diagnostic test is MRI, I just didn't know whether or not you would have to rule out peripheral artery disease as the cause of the pain with walking before you did the MRI.
