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diagnostic tests explained

X-rays - A study using radiation to expose a piece of film with a resulting image. Most of us have seen an X-ray before and the most prominant thing you probably remember is seeing bones. That is what X-rays "see" the best, bones. They can render some soft tissue, like a tumor for example, but there are much better tests for looking at that. X-rays are a relatively inexpensive test that shows things like fractures, alignment of the bones, and the spaces between them (joint spaces). Best for seeing: broken bones (fractures), Arthritis or degeneration of a joint (decreased space between the bones means less cartilage to protect the bones), an effective way to screen for Tumors which would need more evaluation if suspected. Top

MRI - Abbreviation for Magnetic Resonance Imaging, another imaging tool. This one uses magnetism and radio waves to create a picture. Unlike X-rays, MRI's clearly define and "see" soft tissue (such as Lumbar or Cervical disc, nerve roots, meniscus' (in the knee) or other cartilage linings in the joint, ligaments (like an ACL in the Knee), tendons, muscles, it can even identify swelling or inflamed tissue, or bleeding in the brain (a stroke)). An X-ray is a single image. MRI's show many images from many angles and slices (imagine taking an apple and cutting it across from side to side at 5 different heights from the table. Now you could take off each layer one at a time and look down at the one below (called a cross section). This is what an MRI would essentiality do. So as you might imagine, it provides a tremendous amount of detailed information. MRI's however are not cheap. Healthcare providers need to be sure that the information they are looking for cannot be gained with a more cost effective test. Often it can't, and an MRI is well worth it's cost. Best for seeing: Bulging or herniated discs (neck or back), pressure on nerves (nerve roots), torn ligaments, muscles, cartilage, and tendons. Top

CAT Scan - Abbreviation for Computerized Axial Tomography. A CAT Scan is basically an X-ray that takes multiple images like an MRI.. The machine actually rotates 180 degrees around the patients body. The X-rays go through the body and hit a sensor on the other side. The computer than analyzes the information and based on the speed it can "see" the density of the tissue and creates a 2 dimensional picture of the body. Best for seeing: Internal structures. Often used to clearly identify tumors and internal organs, or guide surgical procedures. It can also be a useful tool to "see" the spine. Top

PET Scan - Abbreviation for Positron Emission Tomography. In this study the patient ingests a radioactive substance which is then transported throughout the bodies circulatory system. The substances radiation can then be detected and used to create an image. This study is frequently used to look at the health or disease of tissue. For example, healthy heart tissue with good blood flow will bring circulation to it so it will be seen in those tissues. Dead, or injured tissues will have low concentrations of the material and not "light up". In contrast, cancerous tissue which generally grows rapidly will have abnormally high concentrations. Best for seeing: Health of a tissue, malignancies. Top

Myleogram - This test can be specifically used to visualize the "spaces" in the spine. A dye is injected into the spine which can be seen by X-ray . Then the patients position is changed so that the dye flows to the desired location. That flow can also be monitored to look for blockages. It can be used to "see" spaces around the disc, bone spurs, nerves, and tumors. Best for seeing: Subtle nerve root compressions, clearly defining bony structure (spinal stenosis). Top

Nerve Conduction - Nerve conduction studies are done to help identify function, damage, or compression of a nerve. Nerves exit the spine and then extend out (like roots from a tree for example). Presure on a nerve at the point it exits the spine can often cause pain down an arm or a leg ("Sciatica"). In a nerve conduction study a small electrical impulse is sent down the nerve (all of our nerves carry small electrical impulses). There are sensors placed at specific locations along the nerves path and they "sense" this impulse as it passes by. By measuring the speed of the impulse at various positions along the nerve the healthcare practitioner can tell if the nerve is functioning properly. If there is compression, often the location can be identified (like the elbow for example).Best for seeing: Locating points where a nerve is compressed, identifying a slowed nerve impulse. Top

DMX - Abbreviation for Dynamic Motion X ray. Using radiation as a normal X Ray would, this techniques shows the same tissues. What is unique about this procedure however is that it takes a video of the motion. In doing so, it can visualize how the bones are moving or not moving during specific motions (turning your head, or tucking your chin to your chest for example). Often in a static film, like an X ray or MRI things looked aligned properly. They may be, in that static position. Then you move and they move when they shouldn't. Best for seeing: Instability in joints from damaged or loose ligaments where a plain film does not show it. Top

Bone Scan - This is a test that is used to evaluate your bones. It is especially good for looking at small fractures that are difficult to see on X Ray, evaluating the stability of artificial joints (ie. Total Knee or Hip replacement), and identifying infections in the bones. It involves having a radioactive dye or substance administered into your body. Then several hours are waited to allow your body to "take up" the dye. A scanner, or camera is then used to take the images and identify areas where the dye has collected. Areas of high metabolic activity will have larger concentrations of dye. Best for seeing: fractures, infection, cancer. Top

Discogram - This is a test used to help determine the anatomical source of a patients low back pain. This procedure is most frequently used to determine if a degenerative or herniated disc is the cause of a patients pain (discogenic low back pain). A needle is used to inject the disc with a radiographic dye. If it reproduces the symptoms that the patient is complaining of, then it is considered a positive test. Then it is confirmed that it is that disc in fact that is the pain generator. This is an important test since often there may be several levels that appear unhealthy but only one is the culprit responsible for the pain. Best for seeing: Identifying a specific disc as "the" pain generator. Top

EMG - Abbreviation for electromyogram. This procedure is usually done to evaluate the function of a muscle. It is typically done with needles requiring the needle to be inserted into the muscle. It measures the activity of the muscle both while at rest, and during a contraction. Best for seeing: Diseases like Myasthenia Gravis, or to evaluate involuntary muscle twitch. Top


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