Do I really need an MRI?

Do I really need an MRI?

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As a keen basketballer (and all round cool dude) I’ve had my fair share of injuries over the years. My knee, ankles, lower back and neck have all had a chance to step into the injury spotlight as I’ve tried my best to stay fit, work full time as a physiotherapist and play plenty of ball.

 

These varied issues now mean I'm somewhat of an MRI veteran (well sort of).

I’ve had a total of 5 MRI scans!!

Now some of you who know me in the clinic, will remember that I only recently injured my ankle. And despite putting myself through some pretty solid treatment and rehab, I re-injured the same one whilst out on the basketball court a couple of weeks ago. Needless to say, I feel I can now better appreciate how frustrating it is when your body is unable to support you doing the things you love.

After consulting with my colleagues (both physiotherapy and rheumatology friends), the collective decision was made to return for a repeat MRI. Now despite working as a physiotherapist, and having had a number of MRI scans before, I found myself questioning things this time around.

  • Was this the best way for me to get answers?
  • Did I really need it?
  • Will this scan really help me understand my ankle rehab and pain any better?

As I pondered the above, I realised that many of my clients might share this line of questioning. So in this blog, I will shed some light on the process involved in an MRI scan and some insight as to why we as health practitioners often find it a valuable resource when used at the right time for the right person.

What is an MRI?

Firstly, the acronym MRI stands for Magnetic Resonance Imaging and it involves a very expensive machine with a large magnet inside. This magnet applies an extremely strong magnetic field and radio waves in order to create an image of the body part in question. The magnetic field produced is about a thousand times stronger than a standard fridge magnet! This field affects the water and protons in our body and causes them to align in a certain way. Each varied type of tissue aligns differently and then returns to normal in a specific way. The machine has receivers which can measure the radio signal of this return and turn it into a computerised image. It then creates slices with these images which can be viewed as cross sectional slices or can be combined to create a 3D image.

One of the biggest benefits of the MRI scan, is that it doesn’t expose our body’s to the risk of radiation- which CT scans and X-rays do. This is particularly important for young children or those who are pregnant or trying.

 MRI Multiple

What might an MRI used for?

Magnetic resonance imaging can be used to image most tissues of the human body and can be used to visualise joints, organs, muscles, tendons, ligaments and more. Generally, this scan is best used for the analysis of soft tissue- such as muscles, ligaments, tendons and organs. An MRI is able to pick up the integrity of our bony structures, but it is still generally felt that an X-Rays or CT scans may be more helpful to assess the bone itself.

You may be sent for an MRI scan if your treating practitioner wants to analyse your muscles, ligaments or tendons after a injury. It could also be used to assess brain structure and function, or help to diagnose strokes, tumours, aneurysms, spinal cord injuries, eye or inner ear problems and more.

So in summary, a health practitioner will refer you for a scan to confirm/ determine the specifics of a diagnosis. They would expect that the scan will help them to accurately decide the next steps. Perhaps a further referral, surgical intervention or other form of treatment. It should also help them understand how long it may take you to recover from the issue.

MRI Machine 

What to expect on the day

Prior to the scan, you will usually need to make an appointment with the clinic and send through the referral (the doctor may do this for you). You will still need to bring the referral and any medicare cards in case there is a rebate available. The referral will have information regarding the area of scan and some history- this will help the reporting radiologist when assessing the scan and they will know to check for particular things. Once there you will be required to fill out some forms to check for certain health conditions or procedures.

Once in the radiology centre, you will be called up and asked to get changed into a gown and to put your things in separate locker. Due to the strong magnet, you won't be allowed to have anything metal with you and they will also check with the forms you’ve filled out that any previous surgeries will be safe.

Once prepared, you will lie on a movable table which will slide into a large donut-looking hole. Be aware that depending on the body part being scanned it can be a bit claustrophobic. Even having my knee scanned it was quite a tight fit! Make the clinic and operator aware if you have any issues- during the scan you will have a button to squeeze if you’re uncomfortable. I have come close in recent scans as my ankle became sore from being in the same position for some time.

The machine is also very noisy (I think it sounds a bit like dubstep) and even though they will give you headphones or earplugs it’s a bit off putting! Larger joints or areas will take more time and in my experience ankles take around 25-30 minutes and knees take approximately 30-45 minutes. Larger body parts can take over an hour. Keep in mind that they may have to re-do some of the sequences if you move- I think I fell asleep in the last one and moved so they had to re-do some of the sequences. HOT TIP: Don’t fall asleep in the scan!

Once the scan is complete, you will get changed and they will usually give you the films in person to take home. The radiologist will then view the pictures to report on your scan and send the results to the referring practitioner. This typically occurs  within  3 working days. I advise that you avoid the temptation to look at the films- it will be hard to read and accurately interpret the results unless you know what a normal scan looks like. I made the mistake of looking at my last films and was POSITIVE I found a crack in my ankle. This wasn’t the case in the end but I learnt my lesson :)

For me, I will likely get the results for my scan through my doctor today. We are hoping that it will help to confirm certain injuries have healed since the initial injury. We also want to make sure that the injury is of a lesser severity and that I don’t need to put my walker boot back on again! (Fingers crossed)

I appreciate the MRI is just one of a number of scans that may be used to help diagnose and manage a particular problem, but hope you have found my experience useful!

Comment below if you’ve had an MRI and let us know what your experience was like!

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