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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17516
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am a female aged 40 with lower back pain on the left hand

Customer Question

I am a female aged 40 with lower back pain on the left hand side for over 2 years. I had an ultrasound in December which showed two small lumps on my liver but my bloods were clear. My specialist told me he wasn't worried as my bloods were clear, however I had a nuclear scan aboput six weeks ago from which I haven't had any results and I have just received an appointment for a EUS scan in four weeks time.
Submitted: 4 months ago.
Category: Medical
Customer: replied 4 months ago.
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Expert:  Dr. D. Love replied 4 months ago.

Hello from JustAnswer.

I assume that you mean a nuclear scan of the liver, correct?

What was the reason for the nuclear scan?

It is not typical for a liver nuclear scan to be done for left lower back pain. Are you having other symptoms?

Customer: replied 4 months ago.
No, I had a small amount of weight loss at the beginning of the year but that has now stabilised.
Customer: replied 4 months ago.
the two small spots that were found on my liver in December. My specialist did mention gall stones but would they use an EUS for that?
Customer: replied 4 months ago.
hello, are you still there?
Expert:  Dr. D. Love replied 4 months ago.

Yes, I am still her, but it takes some time to type a complete answer.

Yes, they would, although more because of gallstones that have Carly Parker Tit Staringassed into and may be stuck in the bile duct.

There are a couple of common possible reasons for getting an EUS in this situation. A gallstone that may be in the bile duct is one of the reasons. If there was a concern about gallstones in the gallbladder, then a standard ultrasound would be able to see them well and an EUS would not be necessary. But since an EUS was recommended, the issue would be a gallstone may be in the bile duct

It is also possible that there could be a filling defect that is worrisome for a lump that is located deep within the liver,, but there are only a few locations within the liver that an EUS can see significantly better than a standard ultrasound.

There also may be a suggestion that there may be a lump around the bile duct that is squeezing the bile duct, and this area can be seen better by EUS than with a standard ultrasound.In this location, it would not be any lump within the liver, but possibly within the pancreas or the soft tssue between the liver and pancreas.

Since he mentioned a gallstone, the first scenario is most likely.

If I can provide any further information, please let me know.

Customer: replied 4 months ago.
If it was anything serious would they let me wait another month for the Eus? Why have they sent me for this without giving me the results of the nuclear scan?
Expert:  Dr. D. Love replied 4 months ago.

Typically no, they would evaluate a serious problem more urgently.

I cannot say why your doctor did not communicate the result.

Customer: replied 4 months ago.
Do you think tha the rib pain is related to my pancrea then. It sometimes feels better when I sit forward but not when I lie down. It's a strange sensation as though something is folding over inside
Expert:  Dr. D. Love replied 4 months ago.

What rib pain?

You only mentioned low back pain, and then weight when I asked about any other symptoms.

Could you describe the rib pain in more detail? Location? Exacerbated by breathing? Is it tender when you press on the rib?

Customer: replied 4 months ago.
The lower back pain is located just under my left rib cage. Not really tender to the touch and does not change with breathing. It feels like something is folding over inside difficult to explain really
Expert:  Dr. D. Love replied 4 months ago.

If the pain in the back is at the level of the ribs, it would typically not be considered low back pain. However, back pain in the location you describe could be related to any of the conditions noted above, not just the pancreas.

Customer: replied 4 months ago.
Am I worrying for nothing
Expert:  Dr. D. Love replied 4 months ago.

It is impossible to say without having the report. Statistically, it is more likely not something to worry about, but it cannot be said with certainty.

Customer: replied 4 months ago.
Would i be able to get the nuclear results if I phoned up.
Expert:  Dr. D. Love replied 4 months ago.

It usually takes more than a phone call, because they cannot verify that it is you over the phone.

Customer: replied 4 months ago.
Would any of the above conditions show any other problems. If I had cancer would it not show up in my bloods?
Expert:  Dr. D. Love replied 4 months ago.

Frequently not, and the answer assumed that the tests were still normal, as you stated in your question.

Customer: replied 4 months ago.
I thought that most cancers showed up in some form in the blood stream?
Customer: replied 4 months ago.
Sorry I know I am going on but the rib pain is constant is this normal for any of the above
Expert:  Dr. D. Love replied 4 months ago.

Ultimately, yes, if left untreated, but most cancers do not cause any abnormal blood tests in the early phases of the cancer. Most screening tests for cancer are not blood tests. We do not decide to skip a cancer screening test, such as a mammogram or colonoscopy, because the blood tests are all normal.

Certain cancers can be far advanced before blood tests are affected.

Any of the conditions can cause constant pain. Of course, back problems also can cause constant pain, and would be the most common cause of constant back pain.

Customer: replied 4 months ago.
One final question, if the big C was involved would it have not caused other problems within the two years I have been suffering with the back pain?
Customer: replied 4 months ago.
Or is it possible that the back pain may not be connected at all.
Expert:  Dr. D. Love replied 4 months ago.

If cancer is the cause of the back pain and whatever was seen on the nuclear scan, then, yes, it would likely have started causing other symptoms in the interim, but it cannot be said that it wold always be true.

As I said above, back problems would be the most common cause of constant back pain, and yes, that would not be connected to anything that would have been seen on the nuclear scan.

Customer: replied 4 months ago.
Would the original ultrasound which found the spots on my liver of been able to pick up problems with my Gallbladder or Pancreas?
Expert:  Dr. D. Love replied 4 months ago.

Sometimes yes, sometimes no. If the standard ultrasound could detect everything that may be seen by a nuclear scan or an EUS, there would never be a reason to perform either a nuclear scan or an EUS.

There are times when all three modalities may see the problem, but each test also may see things not seen by the others.

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