Do I Need an X-Ray or MRI?
What is a MRI?
MRI stands for magnetic resonance imaging. It uses a magnetic field and radio waves to produce an image of the soft tissue structures in your body. A contrast between the various tissues of the body can be seen, making its application useful for muscle, tendon, bone, and organs such as the brain. An MRI is useful in determining things such as a tear, bulging discs, and nerve compromise to name a few.
What is a Xray?
An x-ray, a form of electromagnetic radiation, is generated and focused through a narrow opening to create a concentrated beam. This beam comes into contact with our tissue where it is absorbed by dense material such as bone and passed through soft tissue such as muscle and fat. The x-rays are then passed to a detector that acts similar to film. The black areas are exposed where the x-rays have reached and the white areas are unexposed as the x-rays have been absorbed by bone. X-rays are useful for looking at the skeletal system and are useful in determining bony abnormalities such as fracture. Some soft tissue diseases can diagnosed as silhouetting of soft tissue is visible.
Is Imaging Necessary?
Imaging such as MRI and X-ray are very useful tools, however, they are not always needed to treat an injury. It is understandable to have curiosity about exactly what is happening inside at an injury site, but it is not always necessary and often does not provide any valuable information. As an example, a person may develop shoulder pain over time that is perhaps related to playing tennis 5 days per week. In thinking of the force required to break a bone, this is an unlikely scenario and an x-ray will likely not reveal anything. An MRI may reveal soft tissue damage, however, healthcare practitioners have several clinical tests that can often reveal what the involved structure is and the severity. With clinical findings, conservative treatment can be pursued. As long as there is improvement over time, it is unlikely anything serious is going on. When conservative treatment has failed, an MRI may be useful in determining source of pain and the extent of the problem. It is important to realize that overutilization of such expensive tests, like an MRI, contribute to rising healthcare costs and increasing insurance premiums. It is important to speak with your healthcare practitioner to determine what your treatment goals are and when an imaging study might be warranted.
Reasons FOR Imaging
- Failed Improvement with Conservative Treatment
- High severity
- Loss of function
Reasons AGAINST Imaging
- Insidious onset
- Improvement with conservative treatment
- Low severity
- No loss of function
Other Types of Imaging
- This is used to image soft tissue structures in the body in real time. Ultrasound is often used in pregnancy to view the fetus.
- Xrays are used along with computer algorithms to image the body. May be used with contrast to view specific structures and their function and can be used to create 3D images of anatomy.
- A radiopharmaceutical is administered to a patient in order to view certain organs such as thyroid, heart, and liver.
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