A Bridge to Destination
The field of medicine revolves around making a timely diagnosis and initiating a proven treatment plan. No treatment is 100% successful, but an accurate diagnosis is vital in achieving better results.
Symptoms, whether it is pain, numbness or weakness related to neck or back pain, are “hints” about the underlying problems. Physical examination adds to these hints to narrow down possible reasons for pain to a handful of medical conditions. X-rays, CT scan and/or MRI add further to this information and gets your doctor closer to the diagnosis. At times, interventional options are needed to confirm or disprove a possible diagnosis.
X-rays utilize invisible electromagnetic radiation to create images of internal tissues on a special film or digital media. Standard X-rays are helpful to look for bone problems; like fractures, deformities, arthritis. Although a few tendon or disc problems might be seen on X-rays, they are not the right choice to confirm soft tissue problems like a herniated or degenerated disc, nerve impingement, tendon or muscle injuries. Radiation is used during X-rays and they are contraindicated during pregnancy. Excessive amount of radiation can be harmful to human body.
X-rays are quick, painless and do not require any special insurance authorization. You will need a prescription from your doctor or their associates to get X-rays.
Dynamic X-rays are specialized X-rays where you are asked to move certain body parts while images are being taken. It helps to identify how your bones move actively with specific body motions. Your doctor may use these special dynamic X-rays when they are suspecting an abnormal motion of your bones or joints, as in case of spinal instability (flexion-extension X-rays) or coccyx hyper-motility syndrome (sitting-standing X-rays). These special X-rays are also fast and do not require any special insurance authorization. You will need a prescription from your doctor or their associates to get X-rays. Depending on your medical condition, you may encounter some pain while going through dynamic X-rays.
Computed tomography or CT scan is a diagnostic imaging technique that uses a combination of X-rays and computer technology to produce images of internal body organs. It shows detailed images of any part of the body, including the bones, muscles, fat, organs and blood vessels. Although most tissues can be seen on CT scans, they are not the best options to see soft tissue injuries in depth.
Typically, a spine or musculoskeletal CT scan takes less than 10 minutes to complete. You are expended to be placed in a wide circular tube while lying on your back during this process. Since the process is fast and the CT imaging tube is quite wide, it is well tolerated even by people who suffer from severe claustrophobia.
Although CT scans are quick and painless, they frequently require insurance authorization by most insurances (except Medicare). You will need a prescription from your doctor or their associates to get a CT scan, even if your does not require authorization.
Magnetic resonance imaging (MRI) is a medical imaging technique that uses a magnetic field and computer-generated radio waves to create detailed images of internal organs and tissues in your body. MRI scanning is a non-invasive and painless procedure.
A spine or musculoskeletal MRI scan takes 15-45 minutes to complete. Most MRI machines are large, narrow, tube-shaped magnets. You are expended to be placed in a narrow circular tube while lying on your back during this process. You are expected to stay as still as possible while in the MRI scanner. You are given a push button to contact your MRI technologist during the test, if needed. You can also speak to your MRI technologist during the procedure. Your MRI technician may allow a short break halfway through the procedure.
During the test, MRI machine makes moderate knocking or banging noises. You are provided withe blankets and ear plugs or nose cancelling headsets to keep you comfortable. MRI is not an easy test for those who suffer from claustrophobia. If you suffer from anxiety or claustrophobia, you may be prescribed a sedative or sent for this scan under sedation. There are few specialized centers on Long Island that offer sitting MRIs to make you comfortable. Image quality of these scanners is not the best, but they can certainly get your doctor better information than a CT scan. Like CT scans, MRI test requires insurance authorization by most insurances (except Medicare). You will also need a prescription from your doctor or their associates to get MRI scan, even if your does not require authorization.
MRI is considered a gold standard to find the cause of spinal pain. It is vital to know that even normal healthy people, who do not suffer from neck pain, back pain or sciatica, may have a degenerated or herniated disc. Having those findings on your reports to not confirm that they are the true cause of your spine pain. A follow up appointment and an in-depth discussion is needed after the scan to understand the findings on your MRI report.
Spine Diagnostics is an area of interventional pain medicine where small doses of Novocaine-steroids are injected at certain targets to confirm a possible diagnosis. These test injections also carry the risks of false positive or negative responses, but overall, along with the MRI findings, they add to the accuracy of diagnosis.
Certain diagnostic injections carry a high chance of confirming or disproving a potential cause of pain, like diagnostic sacroiliac joint injections or selective nerve root blocks. In this section, we will focus on some of the commonly performed diagnostic interventions for spine. Non-spinal diagnostic injections, like vehicular nerve block or intercostal nerve blocks are covered in other sections of our website. For more information, consult our interventional spine specialists.
Pertinent Spine Diagnostic Interventions
- Selective Nerve Block
- Medial Branch Block
- Sacroiliac Joint Injection
- Piriformis Injection