Aren’t X-rays and MRI’s infallible?
I used to think that imaging is the one certain thing in medicine. A friend’s broken pelvis taught me differently. It was fractured, whether we had evidence of it or not. I was one of the people who believed in her the whole time, but her treatment would certainly have been drastically different if her doctors had.
My neck has been giving me more trouble than ever. The Radio Frequency Ablation from last summer must be wearing out again. A few weeks of Oh it will get better has not made it so. Like many of us, I dread the next MRI. Here are a few things to remember when the time comes.
7 things to consider when you get imaging such as MRI
1) MRI to detect inflammation. Researchers in Greece studied the The usefulness of magnetic resonance imaging of the hand and wrist in very early rheumatoid arthritis. Very early Rheumatoid Arthritis or VERA is characterized by bone edema, synovitis, and marginal erosions that cannot be assessed by x-rays. They found that “MRI, by detecting these lesions, may play an important role in the management of these patients.”
2) Position. A radiographic technologist explained to me the importance of diverse positions for x-rays to be of any value with RA. She said my x-ray order would only have been sufficient if I had been in a car accident, but not for RA. Imaging can be done from various angles or sides with certain machines such as the stand-up MRI. X-rays and ultrasound can also be done with motion. I haven’t had it done, but patients and technicians tell me it’s possible. And I’ve read about it in fairy tales journals.
3) She also described the benefits of stand-up MRI, especially with the spine. If that procedure is new to you, you’ll love this page full of case studies about what a difference the stand-up MRI made for some patients. You will be STUNNED at the impact the stand-up MRI made in so many diagnoses and treatment decisions.
4) Musculoskeletal ultrasound (MSUS) is operator dependant, requires extensive experience, and few are expert at its use yet in the States.
5) Save hamburger buns for hamburgers. The “hamburger bun” is a type of MRI that makes a patient the middle of the sandwich. It is slightly less invasive than a tunnel-shaped MRI. However, unless the problem is very simple or the time in the machine is intentionally extended, the lower quality image is makes it the wrong choice for many.
6) Different imaging tools are more appropriate with different anatomical parts or particular conditions. For example “MSUS may be used for investigating median nerve impingement by detecting nerve swelling proximal to the point of compression” or “for quantifying cartilage within the joint spaces;” while “In most joint regions, MRI is better than MSUS for finding erosions,” The Pros and Cons of Ultrasonography for Rheumatologic Conditions.
7) The stars have to be aligned properly. Seriously, nothing is foolproof – even imaging. All tests must be performed, read, and interpreted correctly. And patients’ symptoms must be paramount.
Note: The March issue of The Spear, my personal newsletter went out over the weekend. If you did not receive one, you can click here and I’ll send you one. You’ll read more about the wild verbena flower image created in honor of my mom’s birthday. I’ve turned it into some lovely t-shirts that could make beautiful Mother’s Day gifts –
click here to see them. (Most of them are there now and more are on the way!)
NOTE: THE NEW RA WARRIOR T-SHIRT STORE IS HERE – Click here!
- 10 Reasons We Might Want a Musculoskeletal Ultrasound (MSUS) of a Joint
- Evidenced-based Medicine or Easy-bake Oven: Tension Between Evidence and Reality
- Ultrasounds for Rheumatoid Arthritis, Part 3
- 10 Dumb Questions About an MRI for Rheumatoid Arthritis
- Hysterical Symptom Diagnosis, Part 1 (about my friends broken pelvis)