When Something Doesnโt Add Up: The MRI That Finally Gave Me Another Lead
When something doesn't add up...
For the past few years, I've been on a long and incredibly frustrating journey trying to understand what has been happening with my health.
At one point, I was labelled as having FND. But from the beginning, I struggled with that label because so much of what I was experiencing simply didn't seem to fit. I kept saying that something didn't add up.
I wasn't looking for a particular diagnosis. I just wanted someone to properly investigate what was happening.
I ended up being sent to A&E multiple times as my symptoms worsened, but repeatedly came away without the answers or investigations I felt were needed.
Over time, my mobility deteriorated. I eventually became dependent on a walking aid. I tried physiotherapy, but I was ultimately discharged from MSK because they felt my symptoms required more neurological input.
I had EMG and NCS investigations, but again, I was essentially left with an explanation of "wear and tear".
Yet the symptoms continued.
The pain.
The weakness.
The pins and needles.
The altered grip.
The problems with my legs and mobility.
And that constant feeling that there was something being missed.
So I kept pushing for answers.
Very recently, I finally managed to get the MRI I had been asking for.
And this time, there was something concrete on the scan.
The MRI showed cervical spondylosis, most marked at C3/4 and C6/7.
At C3/4, there is a degenerative disc with reduced height, a posterior annular bulge and prominent bone spurs, or osteophytes, causing cord abutment and narrowing where the nerves exit the spine, particularly on the left.
At C6/7, there are also degenerative changes and osteophytes, with left-sided exit foramen compromise.
The overall conclusion was:
"Cervical spondylosis most marked at C3/4 and C6/7 with left-sided exit foramen compromise by osteophytes at these levels."
Importantly, the report does not describe gross spinal cord compression or an acute disc protrusion, but it does provide physical findings that now need to be properly considered alongside the symptoms I've been experiencing.
And that is the part that matters to me.
For years, I've been saying:
"Something doesn't add up."
I wasn't saying I knew exactly what the answer was.
I was saying that my symptoms deserved a proper investigation.
The MRI doesn't suddenly provide every answer, and I'm not claiming that every symptom is explained by what has been found.
But it has finally given doctors something tangible to investigate further.
There is now a documented spinal abnormality. There are areas where the nerve exit pathways are compromised. There is cord abutment at C3/4. And I'm continuing to experience neck pain, pins and needles and altered grip strength.
I'm now awaiting further neurological input, with a referral to spinal services having been agreed.
After years of appointments, A&E visits, tests, referrals, physiotherapy, setbacks and constantly having to push for answers, this feels like an important moment.
I just want to know what is actually happening to me.
This isn't about proving anyone wrong.
It isn't about saying FND was definitely the wrong diagnosis.
It's about recognising that when a patient keeps saying "this doesn't fit", sometimes that deserves another look.
I know my body.
And I knew something wasn't adding up.
Now, finally, there is something on an MRI that gives us another avenue to investigate.
The journey isn't over. But after years of searching for answers, I finally feel like I'm getting somewhere.
This is where I think FND can become a distraction.
There is an important difference between recognising a functional presentation and treating FND as the reason for that presentation.
Weakness, tremor, altered sensation, gait changes, variability and other so-called functional features may be things we observe. But once those observations are bundled into an FND diagnosis, the diagnosis can start functioning as the explanation for why they are happening.
That risks reversing the logic.
Instead of asking, "What is causing this presentation?", the answer can become, "It is happening because the patient has FND."
But if these same kinds of features can occur alongside many neurological, structural and systemic conditions, perhaps "functional" is sometimes better understood as part of the presentation rather than as the underlying cause.
The danger is that FND then stops being a description of what is being seen and becomes a reason not to keep looking.