I was recently diagnosed by my doctor with MS. My MRI shows 9 T2 Hyperintense lesions in the white matter that are supta juxtical in nature as well as 2 foci in two other areas of the brain.

I saw a neurogist for EMG testing on my arms. She decided to look at the MRI picture and disagrees with my doctor and the radiologist. She stated that it is not MS but could be brought on by HIgh blood pressure (mine is well controlled over last 2 years) or migraines (which I do not get). All my symptoms from numbing, tingling, stabbing pain, mobility issues, blurry watery eyes, etc does not explain. I have DDD in the lumber, SI joints and cervical areas of my back but what I have been experiencing over the last 15 months is different that the pain I experience in my back and knee joints.

Is there a way to differentiate between lesions. I thought that I met the McDonald criteria.

I was recently diagnosed by my doctor with MS. My MRI shows 9 T2 Hyperintense lesions in the white matter that are supta juxtical in nature as well as 2 foci in two other areas of the brain.....Is there a way to differentiate between lesions. I thought that I met the McDonald criteria.

In direct response to your question, the MRI can only distinguish abnormal tissue from normal*. It is a diagnostic tool used in conjunction with other symptoms and signs that must be interpreted in aggregate by your doctor(s). Therefore, independently, the MRI is non-specific and cannot differentiate by disease or disorder. "Diagnosis of MS requires elimination of more likely diagnoses and demonstration of dissemination of lesions in space and time," according to McDonald criteria. (link below).

The McDonald criteria is another tool aiding in differential diagnosis (MS v.) but still leaves room for interpretation.

While I cannot get into interpreting the symptoms you list*, it is safe to note that regardless of the ultimate diagnosis it falls squarely within the domain (specialty) of neurology and it seems the neurologist you mention is making/made the appropriate considerations (based on my reading of procedures).

It also sounds like you have done your homework but just in case you need additional information here are some links that may be helpful:

T2 Hyperintense Signals on MRI (http://www.medhelp.org/posts/Neurology/Meaning-of-T2-hyperintense-signal-on-MRI/show/296604)

Background of McDonald criteria (http://www.va.gov/MS/articles/Diagnosing_MS_Using_the_McDonald_Criteria.asp) and

McDonald criteria (http://www.va.gov/MS/articles/2010_McDonald_Criteria_Revised.pdf)


*As a physiological psychologist I am familiar with normal neurologic function (how things are supposed to work) but not qualified in neuropathology, that is, the diagnosis and treatment of neurologic disorders. Likewise, my knowledge of instruments (MRI, etc) is operational and does not extend to interpretation of results.