Does MRI tell anything?

About 4-5 years ago (pre-menopausal at the time), I was experiencing some very low back pain. I did everything under the sun to find out the source of the pain and correct it. A spinal specialist took x-rays and an MRI. She said I had one of the healthiest spines she had ever seen. My height has never changed. In fact, at my last check-up, I grew 1/4 inch - lol! After quite a while, the pain finally went away, but my question is, is an MRI a pretty good indicator of bone issues if there were any? I know it doesn't give bone density, but wouldn't it show any small fractures, etc.? Also, after reading some past discussions, I'm confused about small-boned women, which I am one. Yes, the bone is small, but it seems wrong to compare a naturally small-boned person to a large-boned person. It sounds like having small bones doesn't necessarily equate to brittle bones. So why would a small-boned person begin treatment if that is just their natural bone size? It just seems like a lot of unnecessary worry for us small-boned women. My 92-year old mother and 75-year old sister have never had a broken bone. I know my mother has never had a bone density test, and I doubt that my sister has either. I'm beginning to wish I'd never had it done. The worry is going to kill me before the osteoporosis.

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MRI can detect small compression fractures of the spine, and is often used to tell if they are new or old, as new fractures cause edema of the bone marrow in the vertebral body, which MRI is very good at detecting, if done with contrast enhancement.

Just one slight correction to your assertion about small boned being compared to large boned. That isn't entirley true. Your bone density is compared to AVERAGE bone density of people with all types and shapes and sizes of bones not just people with large bones. But if you use the FRAX tool and play with height and weight, it isn't the height as much as weight that affects fracture risk. THe thinner you are, the higher your risk of breaking a hip, regardless of the size of the hip bone. That is because you have little or no padding to cushion the blow. One inch of fat overlying the hip reduces the stress transmitted to the bone in a sideways fall (most common hip fracture) by a factor of 20. Being a normal weight or even overweight, all reduce hip fracture risk.

Height is really only a large risk if you are over 5' 9", where apparently, the taller you are the harder you fall starts to creep into the equation. If you are over 5'9" AND are underweight, then things really start to get bad. Runway models in high heels come to mind. It would be an interesting study to follow them after menopause and see what a lifestyle of starving does to their risk of fractures when they are out of the business.

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Well, until recently I was 15-20 lbs. overweight. I've been eating healthier and working out since the first of the year to lose the weight, but sounds like I should put it back on ;-) and finally, after 55 years, it's paying off to be short @ 5' 3-1/2"! Thanks for your comments dxaguru.

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Dxaguru,

Thanks for all of your posts which I always find very informative and helpful.

The short story is that I've had an MRI (as well as spine and rib X-rays, and a CT scan) which have not provided any explanation for the pain I have been experiencing for about a year in the area where my ribs meet the spine. Is there any other test that could give me a diagnosis or should I just add this to the list of things that I live with?

Thanks so much,
Uma

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