Thus, a deposit starting in the bones of the spine or between the bone and meningeal covering can cause pressure on the spinal cord. Because the outside part of the meninges is called the dura, these deposits are called extradural lesions (‘extra’ meaning ‘outside of). Symptoms depend on the location. They often include pins and needles, loss of feeling and loss of strength in the feet and legs, and partial or complete loss of control of bowel and bladder. Extradural lesions cannot be seen on a plain X-ray. They do show up on a CT scan. Another way of ‘seeing’ them is with a myelogram. Here a liquid contrast material is injected into the spinal fluid through a lumbar puncture needle. Because the liquid is heavier than the spinal fluid, it ‘settles’ in the lowest available location. The person can be safely tilted up and down at different angles on a special ’tilt table’ to get the contrast material to the trouble spot.
I have discussed in detail how we can look for secondary deposits in the common sites: the lungs, liver, bone and central nervous system. The same type of approach applies to whatever part of the body is suspected of containing secondary lesions. Suspicions based on symptoms, findings on clinical examination or blood tests may be followed up by appropriate X-rays, scans, biopsies etc. Ask your doctor for an explanation if you don’t understand why certain tests are recommended. You have every right to refuse tests, for example, if you can’t see what difference the results would make to your care.
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