X-Rays and Scans
We are able to refer you for an X-Ray or scan if required. Over the years we have tended to refer less frequently for scans. In certain circumstances a scan can be particularly useful to guide decision making but often and especially in the case of ‘garden variety’ back pain it makes little difference to treatment and some research has even found that obtaining results from a scan can negatively impact your mental outlook on your injury and lead to poorer outcomes. One of the mottos we believe in is: ‘treat the patient’ not the scan.
So when should I have a scan?
X-rays can be used to assess for fractures particularly at the ankle, foot and upper limb. Sometimes they are also useful to help detect scoliosis in the spine or the presence of osteoarthritis in the hip or knee. After acute injury they can also be used to assess displacement of bones, from this we can make conclusions on ligament integrity. A weight bearing x-ray is often useful to assess the width of the ankle mortise when a high ankle sprain is suspected. Similarly a weight bearing x-ray can be used to detect Lisfranc injuries of the mid foot. With an AC joint injury of the shoulder an AP x-ray can determine the grade of injury.
Ultrasound is an imaging procedure particularly useful around the hip and shoulder. Ultrasound is particularly useful in imaging tendons. Tendon tears, tendinopathy and calcification are all conditions we can detect with an ultrasound scan.
MRI is useful to image almost all any musculoskeletal tissue. It is frequently used for knee injuries where there is a suspicion for ACL injury or meniscus tear. When symptoms warrant its use it can also be used to assess the discs and nerves in the patient with back pain.