Magnetic resonance imaging (MRI) has become a common tool used in orthopedic surgery in recent years. Doctors often get them to evaluate acute bone or joint injuries or chronic pain. You might wonder why you need an MRI or what is involved. Here are answers to some of the common questions patients have about these studies.
What is an MRI?
An MRI is an advanced radiology test. You lie on a table inside a machine that takes hundreds of images. The test usually takes about 30 minutes.
Should I get an x-ray or MRI?
What structures can doctors see on MRI?
These studies can show all of the anatomical structures of a body part or region. They are best used to visualize soft tissue structures. Examples of structures that can be seen on MRI are ligaments, tendons, intervertebral discs, menisci, articular cartilage, and muscles. They can demonstrate abnormal appearances in the structures, partial or complete tears of them, and much more. An MRI can also detect a bony injury when x-rays might not detect an abnormality, such as a stress fracture.
When do patients need x-rays versus an MRI?
X-rays are good radiology tests to look at bones. A fracture frequently appears on x-rays, so an MRI might not be necessary. An x-ray can also show evidence of joint degeneration, like knee arthritis. As discussed earlier, most orthopedic surgeons prefer to obtain baseline x-rays of bones or joints before proceeding to more expensive tests like MRIs.
X-rays vs. MRIs: Do I really need x-rays?
Should a patient get an MRI before seeing an orthopedic surgeon?
Many insurance companies will not authorize the test without a doctor or qualified healthcare professional, like a nurse practitioner or physician’s assistant, seeing and examining the patient first. Also an orthopedic surgeon can diagnose many injuries by taking a history and performing a physical exam. The history and physical alone can minimize the need for an MRI. While there are exceptions, generally seeing a doctor first before getting this test is appropriate.
What is an MR arthrogram?
Tears and other abnormalities of some structures can be hard to see on routine MRIs. Occasionally a radiologist will inject contrast into the joint to increase the accuracy of the test. This test is called an MR arthrogram. The contrast can help to differentiate partial or complete rotator cuff tears, detect labral tears of the shoulder, and much more. You might experience discomfort from swelling of the joint by the contrast for several days.
Are there any risks to getting one?
There are thought to be few, if any, long-term risks. There is no radiation involved in this test. A patient with metal on the inside her body, like a pacemaker, needs to alert the radiologist because the magnet could cause some metallic objects to move and cause injury. Some of the machines require the patient to lie inside a long tube for 20 to 30 minutes. Many patients feel a sense of claustrophobia. Depending on the injury, some studies can be performed with open MRI machines. The radiologist might use a machine that only requires your arm or leg inside the magnet.
It is important to discuss whether you need one of these tests with your orthopedic surgeon or primary care provider. These tests can be very helpful in making the diagnosis for many musculoskeletal injuries.
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