Imaging techniques such as X-rays, MRI, and CT scans play an important role in diagnosing and treating various musculoskeletal injuries. Each imaging method serves different purposes and is best suited for visualizing specific types of pathologies. In this blog post, we'll explore when you might need one of these scans, what to expect from them, and how they are integrated into physical therapy treatment.
X-rays use radiation that passes through your body and is captured on the other side, creating an image based on the varying densities of tissues. They are commonly used to diagnose issues in bones and joints, such as fractures or osteoarthritis.
The procedure for an X-ray is typically straightforward. You may lie down or stand while the machine is positioned over the area of interest. Your radiology technician might take multiple images and adjust your position slightly to improve visualization. Each image is recorded in a fraction of a second. Generally, you don't need to follow specific precautions regarding eating or drinking before the imaging. However, in certain cases, a contrast dye may be injected or swallowed, primarily for imaging the digestive system or cardiovascular structures.
X-rays are frequently used in emergency situations to rule out fractures and can also be employed as initial imaging for prolonged pain due to their cost-effectiveness and ease of administration.
Magnetic Resonance Imaging (MRI) uses magnetic fields and radio waves, rather than radiation, to produce detailed images. It creates these images by recording movement of tiny particles called protons that are throughout your body. MRI is much better for visualizing muscles, tendons, and ligaments compared to x-rays.
The MRI process is more complex and time-consuming compared to an X-ray. You lie on a table that moves into a cylindrical tube, either head or feet first, depending on the area being imaged. MRIs typically take between 15 and 90 minutes and can be quite noisy. Some people find the enclosed space of the tube uncomfortable, especially if they experience claustrophobia. However, some facilities offer "open" MRIs, which have an open design on the sides but still have some structure above you, potentially alleviating feelings of claustrophobia. It’s important to avoid having any metal on your person including jewelry, piercings etc as these can be hazardous around strong magnets.
MRIs are usually performed after an X-ray and are useful for detecting tears in structures like the labrum, meniscus, or ligaments. Sometimes, a contrast material may be injected via IV to enhance visualization of these structures. MRIs also provide better visualization of fluid in tendons compared to an x-ray which can help with a diagnosis of tendinitis.
Computed Tomography (CT) scans utilize a rotating X-ray machine to capture detailed, cross-sectional images of the body. This technology allows for more precise visualization than traditional X-rays by combining multiple X-ray images taken from different angles into a series of "slices." Each slice typically measures between 1 and 10 mm thick, depending on the area being examined. The computer then reconstructs these slices into a detailed, three-dimensional image of the scanned area.
The CT scan process is generally more comfortable than an MRI. You lie on a motorized table that slides through a ring-shaped machine, which is less confining than an MRI tube. The procedure usually takes about 10 minutes and is relatively quick compared to an MRI. The machine might make some buzzing or clicking noises during the scan, but these are normal and not typically bothersome.
One of the significant advantages of a CT scan is its ability to provide a clearer and more detailed view of bony structures compared to an X-ray. CT scans are also valuable for planning surgical procedures, as they offer a comprehensive view of the area in question.
In some cases, a contrast dye may be used to enhance the images further. This contrast material is usually administered through an IV, and it helps highlight specific areas of interest, such as blood vessels or tumors, making them more visible on the scan.
Imaging plays an important role in diagnosing musculoskeletal injuries and guiding treatment plans. It can confirm findings from physical examinations and help plan surgical interventions if needed. Imaging is also used to assess the progress of treatment and ensure no underlying issues are being missed when physical therapy outcomes are not as expected.
However, it’s important to recognize that imaging results do not always directly correlate with symptoms. Research has shown that imaging findings, such as those from MRI or CT scans, may not always reflect the source of pain or discomfort. We know this because individuals with no pain can still have abnormalities visible on imaging studies. You can see below that as we age, these findings become more common and are not always indicative of a problem.
This means that while imaging is a valuable diagnostic tool, it should be considered alongside other factors, including your physical symptoms, activity levels, and overall functional limitations. A comprehensive approach that integrates imaging results with clinical evaluation and patient history is essential for effective treatment.
If you have any questions about how your imaging results relate to your treatment or if you need help understanding them, don’t hesitate to schedule an appointment with one of our physical therapists at Maven.
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