Types of Diagnostic Exams

X-ray

An x-ray is a painless, non-invasive imaging process that utilizes photographic film to absorb electromagnetic radiation transmitted through a material body. These images, also known as radiographs or roentgenograms, are used to diagnose and monitor the treatment of various disorders.

CAT/CT Scan

A CAT (computed axial tomography) scan is also known as a CT (computed tomography) scan. It is a painless imaging technique that utilizes a computer to produce detailed three-dimensional images of a body from a collation of cross-sectional x-rays taken along an axis. Of all the imaging techniques that are currently available, the CAT scan is best able to produce images of bone, blood, and soft tissues.

MRI

MRI stands for magnetic resonance imaging. It is a non-invasive technique for imaging the spine that involves rotating a magnet around the body and exciting its hydrogen atoms. A scanner is then utilized to detect the energy emitted by the excited atoms. MRIs provide exceptional detail of the spine's anatomy, since the human body is composed primarily of water, which is two parts hydrogen. An MRI is the single most useful test available for diagnosing spinal disorders.

Myelogram

A myelogram involves injecting a radiographic contrast dye into the sac (dura) surrounding the spinal cord and nerves, and then taking x-rays of the spine. This allows the radiologist to specifically x-ray the nerve roots. In this way, any abnormalities within the spinal canal can potentially be identified to aid in the diagnosis of certain spinal problems, such as nerve compression or a disc rupture. The test can take a few hours. Some patients will experience a headache after the exam. This headache may be severe and last for two or three days. Laying down and drinking plenty of fluids afterwards is typically helpful.

Discogram/Discography

Discograms may be done to establish whether a degenerated disc is causing your back or radicular pain. This exam is generally done in the lumbar spine, but may occasionally be performed in the cervical region. The procedure may be done in the radiology suite by a radiologist or in the operating room by a surgeon. Fluoroscopy is used to ensure proper placement of the spinal needle into the disc. Radiopaque dye is then injected into the disc nucleus. In a normal disc the dye will be contained within the central nucleus. If the dye leaks out of the nucleus in to the surrounding tissue, then the disc is considered to be abnormal. The exam can cause discomfort, is typically done under local anesthesia and takes about 45 minutes.

Bone Scan

A bone scan involves intravenously (IV) injecting a small quantity of a radiographic marker into the patient, and then running a scanner over the area of concern. The scanner detects the marker, which concentrates in any region exhibiting high bone turnover. A bone scan is utilized when there is suspicion of tumor, infection, or small fractures, i.e., conditions that all result in high bone turnover. A bone scan does not replace the above tests, but may provide additional information by eliminating other serious problems.

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