There appears to be an association of chiari (“a hindbrain malformation characterized by downward anatomical extension of the cerebellar tonsils below the foramen magnum, and is thought to result from a developmentally small posterior fossa.”) and FM. This however, is manifest on positional scans (in extension or flexion). To add to the number of MORON studies I have already seen, a study is done in static neutral position and finds nothing. This just adds to my contention that MRI’s are useless (particularly when humans are involved).
My Daughter and I are doing a survey of women with Fibromylagia. If you have Fibromyalgia, could you be so kind as to click here: Survey
Neurosurgery. 2010 Nov 30. [Epub ahead of print]
Is Chiari-I Malformation Associated with Fibromyalgia?
Watson NF, Buchwald D, Goldberg J, Maravilla KR, Noonan C, Guan Q, Ellenbogen RG.
abstract here
To make things worse, they did not match FM subjects with controls – the FM subjects were 10 years older (50 versus 40). This reminds me very much of the most evil moron study ever done – the women’s health initiative. One of the authors of that study went on record as saying they were out to prove estrogens were harmful for women. So, they took even 80 year olds and started them on estrogens – well of course they were harmful. It was only much later when age analysis was done, that it was realized that under 60, estrogens reduced breast cancer and heart disease and very significantly reduced death rates. I think those initial authors should be put in jail….
Now in this study they take FM subjects 50 years old. Anyone with a chiari would probably have had significant enough symptoms by that age to no longer be in a pure FM catagory – they would have had too many neurological symptoms especially with balance. So there would be an exclusion bias eliminating protential chiaris by that age.
Then of course only do an MRI in neutral position when multiple studies have already demonstrated that it appears in flexion or extension. Sure, they made mention of that fact in their article, but that is not what will be remembered when others quote their negative findings. This is an evil study meant to get negative results and I can only assume that is what they wanted to find.
Only good thing is that if you have Fibromyalgia, don’t bother getting an MRI. You would need an MRI in flexion or extension, preferably upright – of which there are about 4 locations in North America that have them – including the one in Kamloops BC.
Addendum – Dr. Heffez, who previously found various causes of cervical stenosis in FM cases, pointed out that the above study found significant neurological findings of cervical myelopathy.
‘‘Is Chiari-I Malformation Associated With Fibromyalgia?’’ Revisited
Neurosurgery August 2011 – Volume 69 – Issue 2 – pp E507-E507.
Heffez, Dan S no abstract
These findings, they did not bother trying to explain. By the older age their subjects were in, cervical spondylosis would be a more likely a cause, and flexion – extension MRI views – [preferably upright] would be necessary to delineate. Their response in my interpretation – they didn’t because they wanted to prove FM was not a chairi so they picked and older group to make their point and they were MORONS…
Final conclusion – if you has Fibromylagia, and have gait and other issues that make you suspect your neck is involved, then get a flexion extension upright MRI. I have one patient who feels they have found a cheaper site to have this done – and I will report back on this….