- Personal Health Information & Self-Help
After Injury Why x-Ray vs. MRI?
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Sports Medicine Resources
Why pushing for an MRI "at first" may not work
After one has an injury, soft tissue damage almost always occurs. Regardless of whether a fractured, broken bone or soft tissue damage; services to diagnose the injury is applied to determine a course of treatment. And a concern that should be understood by the patient: When should you have an x-Ray vs. an MRI?
It is most probable you’ll be referred for an x-Ray at first to diagnose the underlying damage of an injury area. Why is this non-intrusive viewing of your inners a gold standard? Because when you injure a joint or muscle area that is swollen, painful and/or discolored, the doctor wants to rule out fractures or other soft tissue anomalies.
If your pain is chronic at the joint, or muscle area and it never goes away surgery may be necessary. Surgery is always the last resort one should seek in order to resolve a soft “partial” tissue tear (muscle, tendon, and ligament). The doctor’s decision making process will follow a medical protocol to determine the extent of the injured area through diagnosis, treatment and follow up.
However, if the pain continues to be unbearable and you now aren’t participating in physical therapy, or have immobilized the area and/or exceeding your pain medication requirements, the next line of medical diagnoses will “now” likely follow.
At this point the primary doctor refers an MRI (Magnetic Resonance Imaging), or magnetic resonance tomography (MRT) to look at the soft tissue and next refers you to an orthopedic specialist. A point-of-interest many patients are not aware. An x-Ray mostly is interested in seeing the bone. And not all “partial, or worse” soft tissue tears (especially muscle and tendon) can be seen using this technology.
Let me provide a bit of advice for those familiar with MRI technology. Before you advocate for your MRI referral, be sure to try the treatment program your primary care physician prescribes. Why? Because you may have a soft tissue sprain (ligaments that hold bone together that are overstretched or torn) as opposed to a soft tissue strain (A muscle or tendon that become overstretched or torn). Sprain and strains can occur in any joint, or along any segment of bone. The most common soft tissue damage occurs in the back, shoulders, wrist, knee and ankles. You may be the “overstretched soft tissue” patient that can be rehabilitated without the use of costly MRI diagnosis services.
Doctor’s are not encouraged to send you for an MRI immediately after injury. Why? Well cost is a given, but this technology does not serve its full purpose until the swelling has gone down and sessions of physical therapy ensue. But there is a point of time passed… That one should self refer for an MRI through their primary physician, when swelling has gone down, therapy sessions are finished and pain is not alleviated. In other words, if you have not healed make a follow up appointment.
You should expect if you have overstretched soft tissue damage, it can take up to 6-8 weeks to heal correctly. But if you have gone for 3 months on a rehabilitative course and your pain management programming is not improving and if you’ve not had an MRI, suspect you may have a soft tissue partial tear, etc. And a soft tissue partial tear can completely tear. You want to avoid a full tear! Why? The only way to repair this is through surgery. Or you can choose to live through the pain and partial immobilization that will follow.
Don’t make yourself a surgery candidate unnecessarily. If you know you have a pain problem as the result of injury and well after physical therapy, self refer through your doctor for an MRI to look at the painful muscle, or joint area. Chances are the orthopedic specialist will see soft tissue damage that can be treated without surgery before a full tear occurs.
You then have an opportunity to expedite the healing process through the findings with a different approach to treatment. You’ll also, alleviate pain and minimize what might be otherwise a lifelong dependency on drugs and more severe pain. I’ve personally been successful in self referring to receive an MRI after the first 2-4 weeks of injury. As always, good health to you and your families!