No lesions

This has prob been asked before loads of times , but me and my husband cant understand how an mri can show no lesions but people (doctors etc) think its ms ?

I would of thought that to get numb legs ,face etc,buzzing ,pins and needles,bladder problems,bad cramps etc something would have to be pressing on your nerves ?

Sam x

Hi Sam

What areas have you had MRIs of?
Cervical spine(neck)
Thoracic spine (upper back)
Lumbar spine (lower back)

Some people with MS have lesions in one of these areas but not in others.

That said, I have similar symptoms to you and am still waiting for my MRI results and my rheumatologist says these symptoms can also be caused by spine degeneration, spinal stenosis, fibromyalgia and ME etc.

The first two can often cause nerve pressure and apparently you don’t always get much pain in your neck and back - although I have that too.

What Dr (s) have you seen? GPs or what sort of specialists?


I’ve had an mri of brain ,Neck and upper back not lower as I had to get out as I was sick .
They have found a disc prolapse c5/6 in my neck but the hospital seem to think this wouldn’t cause all of my symptoms . As its pressing on the left side and most of my symptoms are on the right . I’m seeing a neurosurgeon on Monday then my neurologist the following Thursday .
I don’t know how the prolapse happened it could have been like it a long long time .
Sam x

The basic answer to your question is that MRI is not perfect.

To be able to detect all the damage that MS causes, MRI would have to be able to "see" at a microscopic level, but the scanners in the NHS are a very long way from that.

Most MSers have visible lesions on MRI. This is because one of the processes in MS is the formation of patches of demyelination which are about 7mm across in size on average and are normally detectable by MRI. The other main process in MS is axonal death; this happens at a microscopic level which cannot be detected by MRI. Some people tend to have more of the axonal death and less of the lesions. Add to this that lesions vary in size - some are quite small and are easy to miss on MRI, especially with the settings that some NHS scanning centres use.

Neuros have been repeatedly told not to rely on MRI to diagnose MS for precisely this kind of reasons. Unfortunately, many still assume no lesions = no MS. That's right most of the time, but NOT all the time. So history, symptoms and clinical exam results are actually more important than MRI results.


Karen x

Thanks Karen :)

Only the radiologist has looked at it ,as my neuro is away on holiday for another week .The report centered around the prolapsed disc .

Maybe my neuro will have a look at it as well ,although im sure the radiologist would have picked up if therte were any lesions ?

Sam x

A lot of neuros don’t know much about MRI so they rely on radiologists. Even if they do know about it, it’s highly unlikely that they would pick up anything different to the radiologist (although it is possible for lesions to be missed - human error affects everything after all).