Apparently My Cysts Are Stable. Even the New One.
I have accidentally become the unpaid quality-control department for my own radiology.
I did not apply for this position. There was no interview. Yet here I am, several years into this mess, waiting for radiologists to sort out what their own reports actually mean.
My Tarlov cysts were visible on imaging in 2022, the largest one mentioned to be 20mm.
Then came the reassuring years of radiological consistency:
2024: Stable.
2025: Unchanged.
2026: Stable.
Lovely.
Except the 2026 report was subsequently amended with individual measurements, including my largest cyst measured at 38 mm.
Earlier reports had described substantially smaller maximum measurements for my "largest cyst".
My international specialist team reviewing the scans independently also believes there has been interval growth.
So naturally, the official New Zealand conclusion remained:
Stable.
But then things became even more impressive.
The 2026 amendment listed another cyst that hadn't been mentioned in the previous reports.
And that cyst was also labelled:
Stable.
This is where radiology temporarily leaves medicine and enters philosophy.
Stable compared with what?
Its previous measurement?
There wasn't one.
Its previous appearance?
It wasn't mentioned.
Its childhood photographs?
I would genuinely like to understand how something can arrive in the medical record for the first time already possessing a documented history of stability.
Apparently my cyst didn't need a baseline.
It simply entered the report pre-stabilised.
At this point, I am beginning to suspect “stable” isn't a radiological conclusion at all. It may just be the default setting on the reporting software.
And unfortunately, this isn't merely funny.
Words like stable, unchanged and incidental have consequences.
They get copied into clinical letters. Specialists rely on them. Referrals rely on them. Funding and treatment decisions can be influenced by them. Eventually a description repeated often enough starts masquerading as an established fact.
Meanwhile, the actual questions remain remarkably basic:
Are we comparing the same cyst?
In the same plane?
Using the same measurement method?
Has it changed?
And if a cyst wasn't previously documented, how exactly have we established that it is stable?
I completely understand that radiology isn't as simple as lining up two pictures and getting out a ruler. Different scans, slices, positioning and measurement techniques can make comparison difficult.
But that uncertainty has to work both ways.
If previous imaging isn't sufficiently comparable to establish growth, then surely it isn't sufficiently comparable to confidently establish stability either.
And if nobody previously documented a particular cyst, perhaps we could start with:
“Not previously reported.”
Then investigate.
Radical, I know.
Instead, I'm waiting while radiology performs a retrospective group project about my sacrum while my specialist team works out what has actually changed.
I don't need certainty where certainty isn't possible.
I would simply like the uncertainty described accurately.
Same cyst. Same planes. Three dimensions. Compare the dates.
And perhaps don't label something stable before you've established that it was there.
Because apparently we've now progressed from:
Stable despite different measurements
to:
Stable despite not previously existing in the reports.
At this rate, the next amendment will simply read:
Stable. Now with bonus cyst.
Which, to be fair, would at least be internally consistent with the rest of the experience.