Services and Procedures
The appropriate modality will be directed by your physician or radiologist, including whether contrast (dye) will be necessary.
What is a MRI?
A MRI scan (magnetic resonance imaging) is a diagnostic test that creates detailed images of the body by using a combination of magnets, radio waves, and a computer. It is used to diagnose or investigate problems affecting bones, soft tissues, and/or vessels.
MRI contrast, or dye, is called gadolinium and it does not have any iodine properties. Contrast is used for several reasons like:
- Detecting scar tissue vs new pathology following surgery
- Characterizing different tissue types
- Enhancing the details of abscessed tissue or infection
- Determining the patency of vessels when doing MR Angiography
What is a CT scan?
A Computerized Tomography (CT) scan, or CAT scan, is a type of imaging that uses rotating X-Ray machines and computers to build a detailed cross-section (or 3D) image of the body. These images can be used to show not only bones, but soft tissues and blood vessels too. CT’s can be used to diagnosis things like infections, diseases, and masses, or to assess injuries.
Contrast with CT Scans
The contrast, or dye, that some CT scans call for enhances blood vessels and other soft tissue structures. This dye may be taken orally (typically for abdominal and pelvic scans) or intravenously. CT contrast typically contains iodine, but some oral contrasts can be barium sulfate.
What is an X-ray?
X-rays use small amounts of radiation to create 2D, gray-scale images of a body part. This is the oldest and most well-known, widely used type of medical imaging. It is most commonly used to detect bone fractures.
Steroid, or corticosteroid, injections are used to treat conditions such as joint pain, arthritis, pain after injury, and more. This is used for temporary pain relief.
Epidural Steroid Injections
Epidural steroid injections are often used to treat pain caused by herniated discs, or other spinal issues. While this is often a temporary pain relief option, it may last long enough to allow the cause of the pain to heal.
Similar to epidural steroid injections, facet joint injections (or facet blocks) are administered into the spine. This minimally invasive procedure may be used to diagnose a problem or relieve pain temporarily.
Tendons are fibers that connect bone and muscle. Tendonitis is caused when a tendon becomes inflamed, often due to overuse or injury. These procedures inject a corticosteroid, along with a local anesthetic, into the area adjacent to the tendon to try to decrease the inflammation and relieve pain. Typically, this treatment begins to take effect 2-3 days post-injection and progressive gets stronger over the following week.
Nerve Root Block/Transforaminal Injections
A transforaminal epidural steroid injection (TFESI), or nerve root block, involves injecting a steroid medication and/or a local anesthetic in the area of the spinal column where the nerve roots exit. These injections can be used as diagnostic tool to find the cause of pain or as a therapeutic treatment to try and get rid of a patient’s pain.
Trigger Point Injections
Trigger point injections (TPI) are used to treat what are typically called “knots”. These are spots in the muscle that won’t relax and can be incredibly painful. A TPI involves inject a steroid medication mixed with a local anesthetic into the affected area to relax the trigger point and alleviate the pain.
Discogram and Arthrogram
Understanding the Discogram
A discogram, or discography, is used to assess a patient’s neck or back pain and may assist in diagnosing a specific area of the spine is to blame.
How it Works
The spongy cushions between the vertebrae of the spine are called spinal discs. The discogram injects a dye into discs believed to be affected, which can help us see where any damage lies.
Why it’s Used
If you’ve experienced persistent pain even after other treatments, your doctor may recommend a discogram to gain a clearer picture of the potential issue.
What to Expect
This is an invasive procedure that may take up to an hour and will require rest at home afterwards. You will be awake during the test to help provide feedback on what you are feeling and the locations of symptoms. During the procedure, you will be lying on your side or back and iodine contrast will be injected into the affected disc(s). You will be asked if you are feeling pressure or pain, and if it is pain like what you experience daily. The information is then used to determine whether a disc is healthy or bad and possibly the cause of your pain. You will need a driver for this test.
Understanding the Arthrogram
An arthrogram is an imaging test used to inspect a joint for causes of pain, including tears or other damage.
How it Works
Contrast dye is injected into the affected joint. X-rays are then used to show the joint in different positions to get a better view of possible problems.
Why it’s Used
Arthrograms are typically used when more detail is needed than a standard X-ray can show. These details include the structure and function of a joint. They may also be used on prosthetic joints.
What to Expect
This procedure involves first cleaning and numbing the skin with a local anesthetic. Then contrast dye (typically iodine and gadolinium) is injected into the affected joint using a C-Arm (a low dose x-ray machine) as a guide and to ensure proper placement. After the contrast is injected, you may be asked to move your joint into different positions for x-rays to show several views of the joint coated with the dye. Patients are typically then taken to CT or MRI for advanced imaging. Arthrograms typically take less than 5 minutes and patients typically just experience a weird pressure in the joint from the dye.
Diffusion Tensor Imaging
An advanced magnetic resonance imaging (MRI) technique, diffusion tensor imaging (DTI) is used to more accurately diagnose traumatic brain injury (TBI). This neuroimaging tool is used to detect the white matter fibers of the brain, which provide pathways to connect different areas of the brain. With DTI, this matter is imaged in more detail in order to measure things such as degree of myelination, fiber orientation, and axonal density. In short, DTI helps reveal details about the brain from a microscopic level.