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How often to get an MRI or another test?

charryccharry Posts: 5,657
edited 06/11/2012 - 8:47 AM in Chronic Pain
How often to get an MRI? I had one last October and a year and a half before that. I still have pain but my second MRI didn't do a weighted exam. I feel they missed something. I also injured myself while at pool therapy with my PT and haven't returned. Since I have DDD do I need a CT scan? What tests have you had? And when they did surgery did they find it worse than what your MRI or bone scan or x-rays showed? TY.
DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN


  • Charry I've had similar problems with MRIs and CT. More than once I caught things that they omitted and had reports revised. I even took my latest MRIs to another radiologist for an "outside read". I've also switched the place where I go for tests because I wanted some place that was independent of any doctor's office.

    As to how many or how often?? Well in the past year I've had 4 sets of neck and recently one set of brain/neck. Each set had multiple tests because they would do a cervical and thoracic seperately. This is certainly excessive but it seems like each time there has been something new happening. In general I would think once a year would be acceptable, unless like me you have new issues.

    As far as surgery -- for my shoulder the doctor was shocked because in the two months the tear had started to heal itself. For my spine he said it was pretty much as expected. However I don't think that doctor really compared the test to actual. Once he was in there he just worked. I'm sure there are always some differences, either better or worse.

  • I have mixed emotions on that whole deal. The surgeon i am with right now I trust everything about him and anything he says. So he does use one place for the imaging, which is easy for me to get to. The radiologist doesn't really write the lengthy reports of everything that is on the films, but then again my surgeon pretty much doesn't use their reports and relies on his own opinions. But sense I am not looking for any doctors in that arena I have no concerns really about it. The only place it doesn't help me is in the arena of work comp and the legal side of it with those reports being so vague.

    AS far as what happened on the imaging vs surgery. For the most part they have found more damage on the surgery as the pre-op diagnoses vs the post surgery diagnoses had a little bit more added to it. But it could have been that in all those cases surgery was done no less than a month following the mri. So is it that it changed in the time or it wasn't seen. I tend to think it got worse in the time as the symptoms were getting worse. So I can't really say it wasn't visible on the MRI. In order to make that assumption it would have been with in the same day or so. Sense I have multiple surgeries only once did they really match and that was using myelogram imaging followed up with CT imaging. Now I have gone for a CT scan and the surgeon sent me back for a MRI. The surgeon I have prefers myelograms over MRI's, but doesn't like to keep exposing me either. I think he prefers it more to keep watching the cord itself. I think when you talk about how often the test should be run depends on how much your symptoms have been changing. For example my last set of films were just a few months apart but I developed serious retention issues in the middle of it hence the need for new films to be sure what he was going to see in surgery and to be sure to have the appropriate doctors involved in it. So I think it is going to depend on what they are watching.
  • I was supposed to have one every year because of the degenerative possibilities of my injury. I don't think DDD generally degenerates that quickly, though- so how often to get scanned should be up to your doctor.

    But this is kind of a good reason to have a regular doctor (something I also haven't had) vs. hopping around. Someone who can make these sorts of calls would be beneficial. My old ortho said every year. My new ortho said "ACK! SURGERY!" So, who knows?

    I had a CT scan just now prior to surgery so he could see how everything would go together, but have not had one on my lower spine before. I had one on my upper body after my accident due to multiple fractures and concern about shoulder involvement. The pics are very cool, I really want to see the new ones :)


    I'm ready for my close-up, Mr. De Mille!
  • Thats really cool. Looks like it should be in a textbook.
  • are a useful tool providing a decent consultant radiography looks and reports on it ..as for when should they be done .i would say when the patient first presents with a problem and then again if the problem get worse or changes and before an operation
  • I was just showing Charry what they look like. I am not sure they always do the 3d model, but at Kaiser they did, and it shows how much more detail the CT gives about bones.

    However, MRI has no radiation involved, only magnets. CTs have radiation involved. So there is that.
  • My last ct was the latest technology called flash ct. It takes the images super fast. About a minute compared to the 5 or so with the old ones. It is also supposed to focus the radiation on just the area being studied.

    CTs are usually very quick but I remember with this one that I thought they had come back to reposition me but they said it was done. And there were over 800 slides.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    Have had either an MRI or a Cat each year - once a year for the past five years .... with a plain old x-ray thrown in every now an then again for tickles and grins :)

    Oh and yes many or plenty during and or after facet injections (Floroscopy) and other MRI's and cats post surgically - that I can't remember cause I was in la la land. Discovered them on the bills!!

    Hope they find your pain generators .... how ever needed and as often as needed to get you some resolution ... or at least a firm DX and Treatment plan.


    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • Last year I had the lumbar and thoracic added in on the MRI side of the house. Cervical I had 2 last year, so far looks like one this year. As was said earlier in this thread I and many others have additional ones when knew troublesome symptoms appear to rule in or out new issues. So far my "schedule for MRI's" has been.

    1. Prior to confirming for surgery.
    2. When worrisome symptoms have come up.
    3. New areas on my spine with problems.
    4. If nothing new, once a year.

    Hope that helps?

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Tiny sidetrack here. Why does your avatar look so grainy? I don't remember it looking like that before. Sorry for the sidetrack...

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Charry, I have no idea how often these tests should be done. Since I have continued to have issues on top of issues after my surgery, NO ONE has said I need further tests. Which is beyond stupid to me!! I have ESI's and who the hell knows where they are putting them. X-rays are all I have gotten. In the meantime, If I press into my back just above my buttocks, I can feel lumpy scar tissue stretching all the way to my waist. It is very very odd feeling!

    I hope you can get some answers. Does Canada offer and guidelines through their healthcare system?

    Replaced offensive word. Changed by authority member, Cath111.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    I will get it fixed .... switched to my recent MRI and then switched back. Had some problems resizing it. If I can't fix it I'll send it to Ron or Tam for assistance.

    Gee and I'm a computer guy ... shame on me! ... but my abilites are becomming more pronounced (dis)-abilites.


    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • Yes HB I like your CT it looks 3D. We don't have any policy here in Canada about MRI's. I know I will need a C-spine MRI because of what the x-rays showed with C6-C7 impinging and the Radiologist even recommended an MRI and I do have elbow pain and numbness in my forearm and finger sometimes but really just wanted to have the lumbar looked after first but a little concerned about stability and that for my neck.

    I also injured my back in pool therapy and haven't been back since and it's been months and I told my Dr. but she didn't say she would order another MRI even when I told her last time my leg gave out on me. I'm so tired of asking for one all the time but I will next time I go so it will be a year since my last one. Well I'll see if she offers one as my foot is so numb. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Here's something I found that might help explain the difference between an MRI and a CT scan:

    An MRI, or magnetic resonance image, is a useful tool in evaluating the spine. An MRI is non-invasive, does not use radiation, and provides good visualization of the spinal ligaments, a herniated disc, bony infection of the spine or disc, a tumor, and spinal cord compression or damage. You cannot have an MRI if you already have a cardiac pacemaker or certain types of aneurysm clips, for example.

    CT Scan
    A CAT scan, or a computed tomography scan, uses radiation to evaluate spinal abnormalities. For instance, a CT scan can be used to evaluate spinal fractures, disc herniation, and spinal stenosis, or narrowing of the spinal canal. CT scanning is more rapid than an MRI, and provides better detail of the bones of your spine.

    If your physician believes that your painful symptoms may derive from an infection or tumor in the spine, he or she may order an MRI. Either an MRI or a CAT scan is used to help diagnose disc herniation and spinal stenosis as the reason for your pain.

    The above is quoted from an article on ABC News Health online.

    I've had two MRIs on my cervical spine and one on my lumbar. My first MRI was when my cervical spine problems began and when the tech brought me the notes immediately after the scan (unusual to get them so quickly, I think), he asked if I'd seen a specialist.

    Then, when I started having lumbar problems, I had an MRI on my lumbar spine and it showed a disc bulge, stenosis, spondylolisthesis and facet problems, so we tried the usual conservative measures before my surgeon suggested having fusion. Once he got in there, he found that my stenosis was worse than he'd seen on the MRI and that my spine was much more unstable than he'd thought. He told me that he was glad he did the surgery when he did.

    Just a few months ago I had another MRI and a CT scan on my neck for ongoing pain. But I think in my case, with the plate in my neck, my doc wanted the CT scan to see if I had complete fusion at all the fused cervical levels. The CT scan confirmed that I'm completely fused.

    So, that's my story and info. Good luck to you in getting the proper imaging and diagnosis you need to help you get better.

  • dilaurodilauro ConnecticutPosts: 9,849
    I have had so many MRI's and CT's over the years, I probably have more bombardment of rays than most laboratory experimental animals.

    For my spine, my physiatrist requests a MRI or CT scan when my clinical symptoms and conservative treatments do not show shows of improving the condition. Then she will set up what ever diagnostic tests she feels is required.

    Now when I started having more signs of shoulder problems, my doctors wanted MRIs and CT Scans done every six months to monitor the progression of my arthritis.

    So, I would really say, it all depends on what is going on with the patient and what the doctor(s) are looking for.

    No date could be too soon or too far IF the doctor requested it.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • AHIP said:
    Much of the growth in imaging use is producing positive outcomes. However, estimates suggest that a full third of imaging procedures are inappropriate, costing the country billions of dollars—between $3 billion to $10 billion annually. For example, use of diagnostic imaging for low back pain is one area under heightened scrutiny, given that research suggests that imaging offers little additional benefit. In 2006, the National Committee for Quality Assurance (NCQA) added a Healthcare Effectiveness Data and Information Set (HEDIS) measure regarding use of imaging for acute low back pain within the fi rst 30 days of experiencing symptoms to address this concern. Asymptomatic individuals represent another population whose increased use of imaging services is questionable. By some estimates, up to one-third of the nation’s health care spending is attributed to the “worried well.” Whole body CT scans are increasingly popular with patients, who often choose to pay out-of pocket for them. There are numerous additional uses of CT and other imaging tests
    for which evidence of effectiveness and value is lacking.
    For example, despite the lack of evidence that screening with spiral CT scans improves outcomes among asymptomatic individuals, it is nonetheless being marketed and utilized for that purpose, resulting in false positives and the need for additional testing.
    More recently, unnecessary exposure to radiation has been raised as a concern especially when attributed to inappropriate imaging. A recent study published in the New England Journal of Medicine suggests that as many as 1.5–2% of cancers in the U.S. may be attributable to radiation from CT scans when adjusted by the current CT use, though no large-scale epidemiologic studies have
    been performed to date. This is because CT relies on larger doses of radiation than its more traditional counterpart—the x-ray. For example, a chest CT exposes a patient to 80-400 times the radiation of a chest x-ray and an abdominal CT results in a radiation dose 50 times greater than an abdominal x-ray.
    Children and pregnant women are two examples of vulnerable
    populations at risk from radiation exposure due to over and unnecessary utilization of services. For example, as the number of CT scans performed each year continues to grow to an estimated 62 million scans in 2006, 4 million are for children. Children are particularly at risk because they are more sensitive to radiation and have more years of life remaining in which to develop radiationinduced cancer. Pregnant women have also been identified as a potential at-risk population, exposed to twice as much radiation as they were ten years ago. Researchers found that from 1997 to 2006, the number
    of imaging studies done on pregnant women increased by 121
    percent, with the greatest increases seen in the number of CT scans. These considerations suggest that the inappropriate use of diagnostic imaging, and the resulting unnecessary exposure to radiation in some cases, have implications for both the quality and cost of
    health care. A better understanding of the factors that contribute to inappropriate imaging use has helped design strategies to promote the appropriate use of imaging services and reduce overuse.

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