If symptoms or clinical exam findings suggest intra-articular pathology, dedicated small field-of-view (FOV) MR arthrography of the hip is considered the imaging method of choice. For symptoms of generalized pain or nonspecific physical exam findings, imaging is best performed with conventional MRI of the pelvis and hip. According to the American College of Radiology Musculoskeletal Imaging Criteria, MRI is the next appropriate imaging method in those individuals with negative radiographs. Anteroposterior view of the pelvis is standard, and dedicated views of the symptomatic hip are often performed in the athletic hip which include cross-table lateral, frog-leg lateral, or Dunn lateral. We invite you to call our office for evaluation and discussion of appropriate treatment.The radiographic examination is a critical component in the diagnostic evaluation and treatment decision-making process and considered the first-line imaging technique in the evaluation of hip pain. We specialize in comprehensive management of acute and chronic spinal problems. If this described your case you may be best served by being evaluated in the clinic specializing in treatment of the cases similar to yours where your history, x-rays and previous treatments will be carefully reviewed, you will be examined and all available and appropriate diagnostic and treatment options will be presented and discussed. In this case further worked-up with additional tests including specialized X-ray studies and/or diagnostic nerve blocks would be indicated. The opposite is true as well and patients can have spinal pain with normal or inconclusive MRI findings. We do see abnormal MRI findings in patients with no symptoms in one of the published studies the prevalence of herniated disk was as high as 22% to 36% while study subjects had absolutely no complaints. For patients who have not done well after having back surgery, specifically if their pain symptoms do not get better or get worse.If the back pain is accompanied by constitutional symptoms (such as loss of appetite, weight loss, fever, chills, shakes, or severe pain when at rest) that may indicate that the pain is due to a tumor or an infection.After 3 to 6 months of low back pain, if the pain is severe enough to warrant surgery and patient did not respond to conservative treatment including spinal injections.After 4 to 6 weeks of leg and/or back pain, if the pain is severe enough to warrant treatment such as spinal injection or similar intervention.Indications for when to get an MRI scan include: The following general rules are usually considered before ordering an MRI scan for a patient with back pain, neck pain or leg pain stemming from a spine problem. Progressive weakness in the legs due to nerve damage.The only time an MRI scan is needed immediately is when a patient has either: Any neurological deficits on their physical examinationĪnother important consideration with MRI scans is the timing of when the scan is done.Symptoms (such as the duration, location, and severity of pain).Everything seen on an MRI needs to be well-correlated to the individual patient’s situation, including: Therefore, an MRI scan cannot be interpreted on its own. Numerous clinical studies have shown that approximately 30% of individuals in their thirties and forties have a lumbar disc herniation on their MRI scan, although they do not have any back pain. The difficulty with the results of an MRI scan, as with many other diagnostic studies, is that the "abnormality" that shows up on the MRI scan may not actually be the cause of back pain. Even though MRI(magnetic resonance imaging) is considered a “gold standard” in evaluating spinal problems it is not perfect.
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