My MDX just started making a weird clunking noise from the left rear near the tire. It makes it a lot when the car first gets out of the garage and then disappears after driving for a while. I brought it to the dealer and they said that they were going to replace the struts and Dampers on BOTH sides - and that they had to order the parts.
When I got the car home, I looked underneath and was shocked to see that the left shock (Damper) was leaking fluid - it was dirty and there was fluid on the garage floor.
I called our Acura dealer and asked if anyone even looked at the car - because this was an easy fix - there was no need to replace half of the rear suspension. Anyway, they said that they didn't look at the car - but drove it and thought that this would be "what would make us happy".
So, with any luck, this problem is only the shock - I'd advise anyone who is hearing noise from the rear to inspect their shocks - comparing one side to the other to see if it might be leaking.