Imaging for Back Pain
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What types of Imaging Techniques are Utilized for a Spine Evaluation?
There are a handful of different imaging techniques we use when evaluating your spine. These are never used alone but in tandem with a physical exam. Some of the most common diagnostic tests are x-ray, CT scan, and MRI. All have a place in treatment and diagnoses, but not all are necessary all the time. When evaluating you for back pain you can expect to have some if not all these imaging techniques. To read more about the anatomy of the back of the neck, please go to this ARTICLE.
X-Ray Imaging for Back Pain
X-rays are some of the quickest and most readily available tools we use for imaging for back pain. We can use x-rays for your neck, midback, and lower back. At your first visit we typically obtain x-rays which are completed in our office and evaluated that day by a physician, physician assistant, or nurse practitioner.
X-Ray images are two dimensional
With an x-ray you can see bones in a 2-dimensional way like you would view any other picture. You cannot see soft tissue such as the intervertebral discs, but you can see the space they create between the vertebrae or back bones. Other things we check are the alignment of the bones on your spine and if you have any breaks in your bones known as fractures. If you’ve had any surgery and have hardware such as screws or rods, we can see that as well.
Common questions about X-Rays:
Are X-rays harmful?
The short answer is no, x-rays are not considered harmful (and are generally safe.)
How much radiation is an X-ray?
According to the American College of Radiology a low back x-ray is equivalent about 6 months of normal background radiation you would get from things such as the sun.
Computed Tomography or CT Scan
Computed tomography or CT scan is another well-known imaging study. A CT scan is useful when trying to create a 3D image of bone, but it doesn’t image soft tissue as well as an MRI does. The upside to a CT scan is it’s much faster than an MRI but it has more radiation than an x-ray. The radiation of a CT scan of the head and neck is about 5 months of radiation you would get naturally, the amount from a spine CT is about the same 3 years of natural radiation from the sun. While there is more radiation in a CT it is still considered safe. Reasons to get a CT scan may be to check on a fusion at the 1-year post -op mark or if you are unable to get an MRI. CT scans can also be more sensitive than an x-ray when picking up a fracture.
CT Scan of Abdominal and Spine
Magnetic Resonance Imaging or MRI
Lastly, a very popular imaging for back pain technique is magnetic resonance imaging or MRI. MRI spine images are derived from a very large and powerful magnet and sends radiofrequency waves to identify hydrogen molecules in your own body to recreate an image based on structures and their density differences. For example, bone will present as a different shade of gray compared to a disc or the spinal cord. The MRI can produce a 3D image unlike an x-ray which is only 2D.
Typically, MRI’s have a very specific purpose or reason other than just to see what’s inside. If someone has specific signs or symptoms during a physical exam or they have not improved with conservative therapy, we may want to obtain an MRI.
MRI or Magnetic Resonance Imaging of the Spine
Common questions about MRIs:
Is an MRI a lot of radiation?
There is no radiation with an MRI because it uses a magnet and the water or hydrogen ions in your body.
Will it affect my other metal implants?
Some people with certain metal implants cannot get an MRI. Ferromagnetic metals like iron, cobalt, or nickel. Usually, joint replacements are not affected during MRI.
Can I get one if I have a Pacemaker?
People with older pacemakers or vascular stents typically are noncompatible but the radiology department should know about this, and they can make a decision that will be safe for you.
Would like to have pictures of all 3 types of imaging. We also prefer to have a standing x-ray since this is what we use.
Written by: Nickolas Godley PA-C and Dr. Gregory C. Keller MD
Related Articles:
- Bones of the Back
- Tips To Relieve Back Pain
- Do You Have Lower Back Pain While Standing?
- X-ray, MRI vs. CT Scan
Watch this video from The Jacksonville Orthopaedic Institute on Why Back Pain Can’t Wait!
Book an Appointment with The Jacksonville Orthopaedic Institute Today!
JOI Physicians continue to offer online new patient appointments. This is another option to make it more convenient to make new patient appointments with less phone hold times to reach a doctor for your back. Follow the link below to select your JOI MD and schedule online. If you have persistent back pain, it is probably time to make an appointment with a JOI doctor for your back!
You can still call 904-JOI-2000 to make new patient JOI Physician Appointments if that is your preference.
To make appointments for JOI Rehab for your back, please call 904-858-7045.