Medical Imaging: To Scan or Not to Scan?
A common question we receive at Your Mobile Physio from injured clients is “should I have an X-ray before my appointment?”
Majority of the time the best answer is to be assessed by our qualified physiotherapists and then be referred for a scan if it is needed. At times it is necessary to go for a scan first to determine if there is a broken bone, which means you will need to be in a cast or boot to allow healing before starting physiotherapy.
Other times it helps a therapist to gain a better understanding of your problem as the imaging is so advanced. The truth is a good practitioner will be able to assess you and determine the source of pain or injured structure with their own clinical reasoning.
Personally, I try to avoid scans as much as possible, as your body absorbs a small amount of radiation or is affected by high powered magnets. Studies have determined that these are very low levels that are not harmful; nevertheless, if it is not necessary, I don’t believe it is worth getting a scan “just in case”.
Anyways, the purpose of this blog is not to scare you off scans; it is to give you a better understanding as to which scan you should go for. This will save you time, money and exposure to unnecessary rays.
Below is a list of the most common scans clients will have to go for when dealing with musculoskeletal injuries:
X-Ray: Provides a view of the skeleton and will show basic fractures and osteoarthritic joints
CT (Computed Tomography) Scan: Offers a more in-depth view than an X-Ray and will show more complicated fractures that X-Ray may miss (such as tiny stress fractures). It will also provide an image of soft tissue structures such as muscle, ligaments (tears) and disc (bulges).
Ultrasound: Provides an image of soft tissue injuries such as muscle tears (Hamstrings, Calves, Shoulder) and tendons (tendonitis)
MRI (Magnetic Resonance Imaging): Is the top imaging for soft tissue injuries (muscle, tendon) Such as Anterior Cruciate Ligament (deep in the knee). Also creates a great image of the spinal cord which is why it is used for lower backs
Bone Scan: Will pick up softer fractures and old fractures and is thus used more for elderly patients.
DEXA (Dual Energy X-Ray Absorptiometry): Will measure bone mineral density and determines whether osteoporosis is evident.