Have your symptoms gotten worse over time? However, the patient complained of postoperative neck swelling pain caused by cerebrospinal fluid leakage; therefore, an additional cerebrospinal fluid leakage exploration and neoplasty were . Symptoms include pain, abnormal sensations, loss of motor skills or coordination, or the loss of certain bodily functions. Are you currently taking any over-the-counter or prescription medications? Get support. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. The most common way to detect brain lesions is with diagnostic imaging scans. a bone scan or CT are more sensitive than plain Xrays (see right hip met and see rib mets).Advanced spine mets can lead to . This content does not have an Arabic version. 8 months now. This image may not be used by other entities without the express written consent of wikiHow, Inc.
\n<\/p>


\n<\/p><\/div>"}, {"smallUrl":"https:\/\/www.wikihow.com\/images\/thumb\/7\/7f\/Read-a-Lumbar-MRI-Step-08-Version-2.jpg\/v4-460px-Read-a-Lumbar-MRI-Step-08-Version-2.jpg","bigUrl":"\/images\/thumb\/7\/7f\/Read-a-Lumbar-MRI-Step-08-Version-2.jpg\/aid11636699-v4-728px-Read-a-Lumbar-MRI-Step-08-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"

\u00a9 2023 wikiHow, Inc. All rights reserved. The causes and treatments for each are very different. Patients with MS can present with motor, sensory, visual, and/or autonomic pathway symptoms. If the first treatment isn't successful, what will we try next? Have you participated in any activities that might explain the pain, such as a new exercise or a long stretch of gardening? To meet the criteria for spinal stenosis, a sagittal MRI should show a dural sac diameter of less than 10 mm at the point of compression. What kind of symptoms are you having? Radiation therapy. Vertebral tumors can cause different signs and symptoms, especially as tumors grow. .st0 { Spinal lesions are commonly spotted on imaging tests. This is the most frustrating thing about dealing with doctors offices. You may opt-out of email communications at any time by clicking on White spots were in several places in my head and down the side of my neck. Typically, the coronal series is not performed. In a series of 40 incidental adrenal tumors,7 only one was found to be an angiosarcoma. This example underscores the importance of differentiating benign from malignant solid processes when possible. This image may not be used by other entities without the express written consent of wikiHow, Inc.
\n<\/p>


\n<\/p><\/div>"}, {"smallUrl":"https:\/\/www.wikihow.com\/images\/thumb\/5\/54\/Read-a-Lumbar-MRI-Step-05-Version-2.jpg\/v4-460px-Read-a-Lumbar-MRI-Step-05-Version-2.jpg","bigUrl":"\/images\/thumb\/5\/54\/Read-a-Lumbar-MRI-Step-05-Version-2.jpg\/aid11636699-v4-728px-Read-a-Lumbar-MRI-Step-05-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"

\u00a9 2023 wikiHow, Inc. All rights reserved. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. For example, if you have a vertebral body that looks more triangular than rectangular, that indicates a fracture. While you can't diagnose your own condition simply by looking at your MRI, if you know how to read it yourself you can explain the issues to others. Additionally, such errors put the imager at risk for malpractice judgments. Major side effects of systemic glucocorticoids. When the tumor can't be removed completely, surgery may be followed by radiation therapy or chemotherapy or both. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Would someone please tell me what those spots probably are. With over 15 years of experience, his clinical interests include obesity and weight management, diabetes care, and preventive care, as well as embracing a holistic approach to primary care. These tests use x-rays, strong magnets, or radioactive substances to create pictures of the brain and spinal cord. Accessed Oct. 19, 2017. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. It is difficult to answer this without seeing the MRI or at least knowing more about the MRI. Spinal cord tumors. (8a) The sagittal scout image demonstrates non-specific enlargement of the uterus. Follow up CT after 1 year of chemotherapy shows further dissemination and progression of the sclerotic metastatic deposits. So you just had an MRI of your lumbar spine (lower back) and you went to see the doctor for the results or tried to read the MRI results yourself. MS lesions may appear as either areas of gray, white, or black spots on an MRI, depending on whether they are new or old. At the 2-month follow-up, the intensity of the spinal cord signal on MRI had almost returned to normal and the 'white cord syndrome' had disappeared. Spinal magnetic resonance imaging (MRI). Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Other people with spinal tumors may be able to offer unique insights. Fig. Lumbar MRI scans are commonly encountered in radiologists' daily practice. The imaging shown in this video is of a normal scan of . Depending on the cause, some types of brain lesions will heal on their own or are treatable. 1 The most common reason for nontraumatic outpatient spine imaging remains osteoarthritis, which is more common in older patients. 1 Xiong T, Richardson M, Woodroffe R, Halligan S, Morton D, Lilford RJ. Notify me of follow-up comments by email. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine. There is a problem with wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. The white line is the cerebrospinal fluid of your spinal canal, which holds your nerves. Laboratory investigations including PSA, and a further MRI study for the prostate, followed by biopsy and histopathology, confirmed the diagnosis of metastatic cancer prostate. Each of the foramen should be about the same size. If we combine this information with your protected Hi everybody. Synovial sarcoma: Proton or conventional radiation after surgery? Tumors of the central nervous system. Spinal cord tumors. The joint is normally lined with lubricating fluid called synovium. The white line is the cerebrospinal fluid of your spinal canal, which holds your nerves. If you have pain, where does the pain seem to start? Your spine has a natural curve at L4 and L5, so it won't be a straight line all the way down. Ernst E. Complementary and alternative therapies for cancer. If the MRI was not done with contrast, it may be helpful. Materials/Methods . Urol Oncol 2003; 21:39-44. 3. Magnetic resonance imaging (MRI) was first used to visualize multiple sclerosis (MS) in the upper cervical spine in the late 1980s. Basic Anatomy of How to Read an MRI Lumbar Spine The length-wise sagittal views, or what I call lengthwise baguette views, are the easiest to recognize. What You NEED To Know About How To Interpret Your Back MRI Results. Plasmacytoma/multiple myeloma and lymphoproliferative tumors are the most common malignant primary spinal tumors. other information we have about you. Lumbar spine MR imaging may detect abnormalities of the kidneys, adrenal glands, liver, spleen, aorta and para-aortic regions, inferior vena cava, or the uterus and adnexal regions. Lumbar spine MR imaging is more likely to detect incidental findings than other examinations because of the higher number of organs and vessels in the field of view. Although corticosteroids reduce inflammation, they are usually used only for short periods to avoid serious side effects such as muscle weakness, osteoporosis, high blood pressure, diabetes and an increased susceptibility to infection. To learn more, please visit our. Would someone please tell me what those spots probably are. http://www.cancer.org/cancer/braincnstumorsinadults/detailedguide/. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Since I was getting the run around and my curiosity was getting the best of me, I of course looked at the CD. This image may not be used by other entities without the express written consent of wikiHow, Inc.
\n<\/p>


\n<\/p><\/div>"}, {"smallUrl":"https:\/\/www.wikihow.com\/images\/thumb\/0\/0a\/Read-a-Lumbar-MRI-Step-09-Version-2.jpg\/v4-460px-Read-a-Lumbar-MRI-Step-09-Version-2.jpg","bigUrl":"\/images\/thumb\/0\/0a\/Read-a-Lumbar-MRI-Step-09-Version-2.jpg\/aid11636699-v4-728px-Read-a-Lumbar-MRI-Step-09-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"

\u00a9 2023 wikiHow, Inc. All rights reserved. The lumbar spine is the area where most back problems, like lower back pain, usually originate. If you are a Mayo Clinic patient, this could {"url":"/signup-modal-props.json?lang=us"}, Marghany B, Metastasis on routine lumbar spine MRI. When your doctor takes an MRI of your spine and sees one or more white spots in your spinal discs, they diagnose them as spinal high-intensity zones. There were white spots like circles on my upper arm. Although the white matter abnormalities seen by magnetic resonance imaging may be similar in non-MS autoimmune demyelination and MS, it is the most important diagnostic tool in the differential diagnosis of the mentioned conditions. Hi there, Yes, people can have white spots without having MS. Dr. Gollogly completed his undergraduate education in biology at Reed College in Portland, Ore. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.mhmedical.com. In the evaluation of the thoracic spine, the most common incidental findings involve the thoracic aorta, paravertebral soft tissues, lung parenchyma, pleura and the mediastinum. There were also images of my head and my neck of course which has been hurting for quite some time now. Paralysis in the hands and legs. If small tumors aren't growing or pressing on surrounding tissues, watching them carefully may be all that's needed. Spinal cancer symptoms vary widely, from difficulty urinating to issues with nerve and muscle control and weakness.Factors such as the spinal tumor type (whether it's a vertebral tumor or spinal cord tumor), as well as its size and patient's age and overall health history may influence which symptoms develop when.. The cyst causes marked expansion of the cord and appears like a regular, symmetric cyst with sharp demarcation toward the spinal cord. T12-L1-there are small end-plate entophytes and there is mild bilateral facet osteoarthritis L1-L2-there are end-plate entophytes and there is mild bilateral osteoarthritis. Neuroscience Group 1.47K subscribers 335 71K views 8 years ago Nurse Practitioner, Penny Bernards, discusses what white spots on your brain detected. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Multiple spinal cord lesions maybe detected in demyelinating (Fig. Online discussion boards, such as those offered by the Spinal Cord Tumor Association, are another option. Do these tests require any special preparation? This video-Understanding an MRI of the Normal Thoracic Spine-is designed for the primary care physician or specialist such as a Chiropractor or Physical Therapist to use to learn how to read and understand the MRI of the thoracic spine. information highlighted below and resubmit the form. Dr. David : there is no visible cortical bone destruction. Follow up CT after 1 year of chemotherapy shows further dissemination and progression of the sclerotic metastatic deposits. In the knee, incidental findings include vascular abnormalities such as popliteal artery aneurysms and popliteal artery entrapment. What are the findings? An MRI of the lumbar spine shows the bones, disks, spinal cord, and the spaces between the vertebral bones where nerves pass through. However, it's possible that none of these abnormalities is the cause of your problems. White spots on your MRI can show up even if you have no symptoms of illness. Is there anyone who has seen the results of their MRI before? The cyst is in a central position, as apparent on the axial T2-weighted image (c). This image may not be used by other entities without the express written consent of wikiHow, Inc.
\n<\/p>


\n<\/p><\/div>"}, {"smallUrl":"https:\/\/www.wikihow.com\/images\/thumb\/a\/ab\/Read-a-Lumbar-MRI-Step-07-Version-2.jpg\/v4-460px-Read-a-Lumbar-MRI-Step-07-Version-2.jpg","bigUrl":"\/images\/thumb\/a\/ab\/Read-a-Lumbar-MRI-Step-07-Version-2.jpg\/aid11636699-v4-728px-Read-a-Lumbar-MRI-Step-07-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"

\u00a9 2023 wikiHow, Inc. All rights reserved. Hello, Common causes of calcifications in the pelvis in a woman of about 50 yrs are a Phlebolith, that is a calcified wall of a vein, a fecolith, that is calcified feces in the colon, or a Calcified uterine fibroid. Copyright 2000-2022 Cancer Survivors Network. But sometimes they may indicate significant damage to white matter that can disrupt neuronal (nerve signal) transmission and interfere with the way the brain works. What kinds of tests do I need? 3.18. ErrorSelect What are the risks? You can unsubscribe at any Gray matter contains neural cells, dendrites, and axon terminals, while white matter consists of axons and myelin, and plays a key role in nerve cells' ability to connect to one another. The central nervous system, which consists of the brain and spinal cord, contains two types of tissue.White matter appears pinkish-white, while gray matter is a darker hue. If the herniation creates too little space for nerves in the spinal canal, this can lead to pain and discomfort. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Subscribe for free and receive an in-depth guide to coping wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. More commonly they represent ischemic white matter disease (microvascular small vessel disease of the brain). Extracolonic cancers were detected in 2.7% and 0.9% had an abdominal aortic aneurysm (AAA). The cyst is located anteriorly on the left side. Clinical and economic impact of incidental thyroid lesions found with CT and MR. AJNR Am J Neuroradiol 1997; 18:1423-1428. Six of these patients had further workup with the cost of each workup being $1158. http://www.merckmanuals.com/professional/print/sec17/ch236/ch236g.html. A doctor who sees you for a possible spinal tumor may ask: Connect with others like you for support and answers to your questions in the Proton Beam Therapy support group on Mayo Clinic Connect, a patient community. What are the risks? Hemangioma is the most common benign tumor of the spine. This includes cervical (neck), thoracic (between neck and low back), What can white spots on spine in mri scan indicate? Tip: If you see a bright, white line running down your spine on a sagittal MRI, you're looking at a T2-weighted image. Merck Manual Professional Version. My arm has been hurting since July. Treatment options for most spinal tumors include: Monitoring. 1 Can a MRI detect bone lesions away from the spine? You can find more information on the complexity of hip-spine in our article: Hip-spine syndrome can lead to failed hip replacement and lumbar spinal . Abnormalities in white matter, known as lesions, are most often seen as bright areas or spots on MRI scans of the brain. health information, we will treat all of that information as protected health MRI uses a powerful magnetic field and radio waves to produce accurate images of your spine, spinal cord and nerves. Inflammation - a variety of auto-immune diseases, from Sjogren's syndrome to lupus . The spine is the third most common site for metastatic disease, following the lung and the liver. Try to get your doctor on the phone as soon as possible. Medically, the vertebrae are labeled with an "L" indicating the lumbar region, followed by the number. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. After the age of 60 years old, about 90% of people have at least a "degenerative disc." Low back pain is one of the most common diseases in the United States. However, the line you draw (including the curve) should still be smooth and even. For example, in an evaluation of 257 renal malignancies,2 93 (36.2%) were discovered incidentally with imaging studies. 3.25. Investigating the presence of various autoantibodies potentially involved in the pathogenesis of demyelinating . The second MRI came up white white spots which was in January 2015, I was then sent for a lumbar puncture, but whatever they were looking for, it came back negative. It derives its name from the way it is seen on an MRI scan as a completely black disc. The T1-weighted sagittal image shows a large abdominal aortic aneurysm (AAA) (black arrows) with evidence of a rupture (white arrows). picture of a bone scan showing 'hot spots' (black areas) which are sites of bone cancer, see the close up of bone scan, and here and here. No studies have been performed to evaluate the frequency of incidental lesions with spine and joint MR imaging, but the types of incidental findings with lumbar spine MR imaging are similar to those seen with CT colonography. The majority of the incidental MR findings involving solid organs are cysts. The AAA was not seen on the diagnostic images of the spine. A 23-year-old female asked: Is it normal for a mri to show white spots on spine not the spinal cord but by the discs in between them Dr. Daniel Clayton answered Specializes in Neurosurgery It can be: It is difficult to answer this without seeing the MRI or at least knowing more about the MRI. Usually uterine enlargement is due to benign fibroid disease, but this needs to be confirmed clinically or with additional imaging. There are many possible causes, including vitamin deficiencies, infections, migraines, and strokes. Two left paravertebral ovoid masses, the smaller one seen at left para-aortic region opposite L2/L3 intervertebral disc and the larger one just lateral to the left common iliac artery opposite L5 vertebra, with a third similar ovoid mass at a lower level laterally anterior to the left iliopsoas muscle, representing enlarged pathological lymph nodes. I don't want you to panic about this. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. What are the white spots on my MRI? The spine specialist refers the patient to a physical therapist before ordering more tests because the spine specialist does not see the hip pain as coming from the spine. During an MRI, you lie on a flat bed that slides into a large tube. (3a) This examination was obtained in a patient with back pain not relieved with conservative therapy. This may be used to eliminate the remnants of tumors that remain after surgery, to treat inoperable tumors or to treat those tumors where surgery is too risky. (12a) Same patient as Fig. Additionally, important non-neoplastic abnormalities can be detected with MR imaging, including ureteral obstruction and reflux, diverticular disease and congenital anomalies. References. These are to name just a few, and as previously noted, these will depend upon location of lesion. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. A T2-weighted MRI scan will typically show white-matter lesionsareas of damage in the white matter in the brain and spinal cordwhich indicate that MS has been present in the brain. This is done under fluoroscopy via a needle and catheter to deliver the medication to the exact spot in the spine desired. A normal healthy disc has a white center (nucleus) but as the disc degenerates its turns a darker color on the MRI scan. With the sagittal image, you get a better overall picture of your lumbar spine. By using our website, you consent to our use of cookies. Additionally, lawsuits alleging failure to order a radiologic examination have grown from 20% to 30% in the last 20 years. The MRI lab had given me a cd to give to the dr. Or speak with a clergy member or counselor. Treatment and prognosis of neoplastic epidural spinal cord compression, including cauda equine syndrome. To provide you with the most relevant and helpful information, and understand which Consider trying to: Find out all you can about your specific spinal tumor. Brunicardi FC, et al., eds. Chir Ital 2003; 55:29-34. This article has been viewed 34,657 times. http://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Tumors/. A contrast agent that helps highlight certain tissues and structures may be injected into a vein in your hand or forearm during the test. Does the pathology affect different parts of the spinal cord with time? Thank you in advance for your help. A standard treatment for many types of cancer, chemotherapy uses medications to destroy cancer cells or stop them from growing. Check with your doctor to see when you can start exercising again. But you're usually given earplugs to help with the noise, and some scanners are equipped with televisions or headphones. Quickly you became confused, overwhelmed, and/or anxious reading all these "bad" things about your back. Surgery.This is often the treatment of choice for tumors that can be removed with an acceptable risk of spinal cord or nerve injury damage. The letter says. Doctors typically provide answers within 24 hours. If your doctor doesn't have any images to share with you, search the internet for "normal lumbar spine MRI." According to some. the unsubscribe link in the e-mail. This revealed marrow infiltrative lesions and pathological para-aortic lymphadenopathy, raising the possibility of metastasis; considering the site and nature of the lesions, metastatic prostatic carcinoma was suggested. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Ask your doctor about support groups in your area. Recovery from spinal surgery may take weeks or longer, depending on the procedure. Here's some information to help you get ready for your appointment, and what to expect from the doctor. Merck Manual for Professional Version. In this case, they are often called "UBOs" for "unidentified bright objects". Spine-imaging volumes are increasing, paralleling the rising number of aging Americans seeking care for back and neck pain. Riggin EA. Research shows that acupuncture may be helpful in relieving nausea and vomiting. 5 Slanetz PJ, Hahn PF, Hall DA, Mueller PR. (10a) The scout coronal plane image shows a complex left adnexal mass in a post menopausal woman (arrows). Incidental lesions found on CT colonography: their nature and frequency. Back pain, often radiating to other parts of your body. [1] Although this will likely be a benign lesion, a solid nodule of this size requires further diagnostic evaluation. Accessed Oct. 19, 2017. Newer techniques and instruments allow neurosurgeons to reach tumors that were once considered inaccessible. You may need this scan to check for spine. For example, the second vertebra from the top of your lumbar spine is called "L2.". It is important for the imager to decide which incidental findings need further evaluation. Laboratory investigations including PSA, and a further MRI study for the prostate, followed by biopsy and histopathology, confirmed the diagnosis of metastatic cancer prostate. For example, most adrenal lesions are incidental non-functioning adenomas, but some of these lesions are more significant. The MRI machine has the capability to re-create your lumbar spine, slice by slice, in three planes: a view from the side (sagittal), front (coronal), and bottom-up (axial). Choose a healthy diet rich in fruits, vegetables and whole grains whenever possible. What is your diagnosis? Additionally, some patients had more than one significant incidental finding. privacy practices. Accessed Oct. 19, 2017. Write down your questions and bring them to your appointments. Your doctor may order one or more imaging tests. 4 Yang G, Chen Z, Peng Y, Liu W, Tao L. [Incidental renal cell carcinoma: analysis of 109 cases]. However, if you have too much desiccation, your vertebrae may grind together when you move. First of all, the MRI of the thoracic spine, as well as the simultaneous MRI of the cervicothoracic spine - when patients complain of pain that occurs in the chest and the corresponding spinal column - is shown to determine their causes. Allscripts EPSi. Dr. David : that is most likely a contast being uptaken in a smorl's node on CT scan or a benign hemangioma in the bone Dr. David : it doesn't look like a bone metastasis on CT scan. a topic. Spinal tumors sometimes might be overlooked because they're not common and their symptoms resemble those of more common conditions. The clinical and imaging aspects of this condition are complex and beyond the scope of . National Institute of Neurological Disorders and Stroke. Imaging tests. In the cervical region, the most common incidental findings involve the thyroid, skull base, and nasopharynx. Various ESFs. Do you have any family history of noncancerous or cancerous spinal tumors? Starting Proton Treatments for Prostate Cancer: Any experiences? Another small focus of low signals on T1 & T2 WIs is noted at S1 vertebra. They never did. MRI scans of a 50-year-old woman with multiple sclerosis. The sagittal (c) and axial (d) T2-weighted images present an ill-defined, hyperdense lesion in the left side of the cord. (1a) T1- and (1b) T2-weighted axial images are provided. I left my name and number again, and still no response. Had deep ache in up back in one spot for over 2 yrs, i have had right breast ultrasound it was ok, mam ok. spine mri ok. shoud i get mri of breast? Because surgery and radiation therapy as well as tumors themselves can cause inflammation inside the spinal cord, doctors sometimes prescribe corticosteroids to reduce the swelling, either after surgery or during radiation treatments. In the shoulder, abnormalities of the lung, pleura and chest wall are the most common incidental findings. Incidental renal lesions unrelated to patient complaints are encountered in up to one-third of lumbar spine MRI examinations [1, 2].In an aging population, the frequency of incidental renal lesions is increasing because prevalence of both benign renal cysts and renal cell carcinoma increases with age [3, 4].Although imaging guidelines on how to confidently characterize renal lesions as benign . Yes, MRI can be used to diagnose and assess arthritis in the spine. Pfirrmann grading system grade I: disc is homogeneous with bright hyperintense white signal intensity and normal disc height grade II disc is inhomogeneous but keeping the hyperintense white signal nucleus and annulus are clearly differentiated, and a gray horizontal band could be present disc height is normal grade III I finally saw an orthopedic dr. that ordered the MRI. The patient initially presented with low back pain radiating to the right thigh, for which an MRI study for the lumbosacral spine was requested. b Sagittal T2-weighted image showing some perifocal edema and another hyperdense lesion at C2. Your spinal cord technically ends before the lumbar region of your spine. Sohrab Gollogly, MD is a board-certified orthopedic surgeon and Fellowship-trained spine surgeon who also performs scientific research and participates in several volunteer surgical organizations. Fractures Since bones show up as white areas on an x-ray and air appears black, an x-ray of a broken bone will be mostly white with a sharp black line running the length of the fracture. But even with the latest technological advances in surgery, not all tumors can be totally removed. I don't know what else, but thought I would throw those out at you. I think Alzheimer's causes plaques, which I think are spots, but you are probably much too young for that. Not all white matter lesions represent multiple sclerosis. They shall be the best people to correlate the MRI findings with your history and examination. Start Here. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. In some instances, very high-frequency sound waves might be used during surgery to break up tumors and remove the fragments.
Savannah River Property For Sale, Articles W