Posts tagged ‘joint’

October 9, 2014

MRI: Not If You’re the Tin Man

Tin Woodman by William Wallace Denslow via Wikimedia Commons Copyright Public DomainWhat are the risks of an MRI?

The main risks of MRI come from the fact that the machine is made up of a giant magnet – which is never turned off.

 

Safety for MRI studies relies on removing any metal on your body and fully understanding the impact of any metal within your body. Many types of metal implants, like joint replacements, are not a problem and patients with them can safely undergo MRI.

 

Some battery operated implants, like most pacemakers and many neurostimulators, can be adversely affected when exposed to the magnet. The safety of any implanted surgical device or metal should be thoroughly discussed before the exam – preferably at the time of scheduling.

 

On the day of the procedure, removing all metal (all hairpins included!) prior to entering the MRI suite is important for the safety of you, the technologist and the machine. No metal in clothing, no metal in pockets, no watches or phones!

 

The other main risk of MRI comes from those studies that require the injection of IV contrast. This allows us to evaluate blood vessels and the vascularity of organs and masses. This contrast contains gadolinium which is a heavy metal. Allergies or reactions can occur, although rarely. Gadolinium contrast materials should be used with caution in those at risk for kidney disease. You will be screened for the possibility of kidney disease, and your kidney function may be evaluated with a simple blood test before we give you the contrast if you have risk factors.

 

MRI is an amazing technology but requires strict safety precautions for everyone. We’ll be writing more about MRIs and the claustrophobic patient in our next post – stay tuned!

(Image credit: Tin Woodman by William Wallace Denslow via Wikimedia Commons Copyright Public Domain)

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

April 24, 2014

Ankles: Sprains and Pains

Image

For any building to be upright, it requires a solid foundation. Such is true for the human body: if what’s below the knees goes wonky it can have an effect on the body as a whole. Ankles are incredibly resilient joints but when they take a hit (or a fall or a twist) they can be problematic.

 

Ankle sprains are common, and can be seen in athletes and nonathletes alike. Sprains can result from the ankle turning from a misstep, from stepping down at an angle or from sideways movements. There are clinical rules which help determine who needs imaging- mild sprains may not need to be imaged.

 

Sprains typically result in injury to the ligaments, those soft tissue bands which connect bone to bone. If the ankle is unstable or if symptoms do not improve as expected, imaging with an MRI may be needed. This allows assessment of the bones of the ankle as well as the soft tissues, including the ligaments.

 

A fall from a height may lead to fracture or dislocation (ouch). Plain films of your ankle will be the starting point if fracture is suspected.  If a fracture is complex, CT is excellent at showing the anatomy and helping your surgeon plan treatment.

 

Achilles tendontears are often an event with a distinct injury, sometimes related to a sudden movement and abrupt tensing of the calf muscle (Remember those replays of Lebron James’ injury? Ouch!). Physical exam will often reveal a focal defect in the tendon your doctor can feel. We may want to image to see if the tendon is completely torn and the distance between the torn ends to help with surgical planning. Ultrasound can show this nicely, as can MRI.

 

Tendons about the ankle other than the Achilles can also be injured, torn or inflamed. Injuries to other ankle tendons can also be evaluated with ultrasound, although MRI is more commonly used. Tendons about the ankle include the peroneal tendons on the outer side of the ankle and the posterior tibial tendon on the inside.

 

It’s important to treat ankle injuries, because as a foundation for the body, adding a limp can lead to other problems including back pain (double ugh). If left untreated, ankle sprains can lead to chronic instability.

 

As ever, prevention is the best medicine. Some ankle strengthening exercises can be found here.

(Photo credit: Broken ankle Cast detail by FiDalwood via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

September 24, 2013

Arthrography: What happens after? – Dr. Angela Noto

September 17, 2013

Arthrography: When is it not used? – Dr. Angela Noto

September 12, 2013

Arthrography: Is lidocaine always used? – Dr. Angela Noto

September 10, 2013

Arthrography: Does it hurt? – Dr. Angela Noto

September 5, 2013

Arthrography: Why is contrast required? – Dr. Angela Noto

August 29, 2013

Arthrography: What are the steps of the procedure? – Dr. Angela Noto

August 22, 2013

Arthrography: for joints? – Dr. Angela Noto

August 8, 2013

Arthrography: what does it require? what does it do? – Dr. Angela Noto