ExpertMRI Blog

Accurately diagnosing soft tissue injuries within the neck and spine can be challenging. What’s more, subjective clinical assessments alone are not enough. According to a meta-analysis of 33 clinical studies, diagnostic imaging was not performed in patients presenting for care—contrary to guidelines—in 65.6% of patients with red flags and in 60.8% of patients with a clinical suspicion of lower back pathology.1
Most attorneys now know that MRI is the recommended initial imaging modality for diagnosing traumatic fracture and soft tissue injury due to its higher sensitivity. It is superior to other imaging modalities (like X-ray) for detecting anomalies of the spinal cord, bulging discs, small disc herniations, pinched nerves and a myriad of soft tissue problems.2 In fact, MRI has achieved reported sensitivities for intervertebral disc injury of 93%, posterior longitudinal ligament injury of 93% and interspinous ligament injury of 100%.3
“Using MRI as an initial diagnostic step for neck and back injuries can not only affirm an initial diagnosis, but may reveal additional pathology,” says Dr. Sana Khan, Medical Director of Expert MRI. “A quality MRI study provides the objective evidence for insurance companies that may be necessary to ensure the patient receives the full amount of care needed for their recovery.”

Khan notes, however, that not all MRI providers are adept at finding the full extent of injury. “Traditional MRI is powerful and accurate, however it fails more than 50% of the time when it comes to identifying cervical spine and ligament damage caused by a whiplash injury.”

Khan claims that the two key elements are needed to identify the true breadth of these injuries. “First, you need a team of radiologists experienced in this type of musculoskeletal diagnosis. Experience really does matter, especially as it relates to soft tissue injury. Second, you need the right imaging tools to identify the injury. In my experience, you need the option to image the patient in multiple positions that are not possible with supine MRI systems, which image the patient when they are lying down. If the pain is only present when the patient is standing, traditional MRI may never identify the problem.”

In addition to high-field MRI, Dr. Khan’s team uses upright MRI systems. These can often reveal problems that would otherwise not have been found.

“Having the right MRI tools at your disposal is so vitally important to diagnosing the totality of injury. When the full extent of the injury is documented, it becomes much easier for that patient to receive the full amount of insurance coverage needed for their treatment, which can often take many months of therapy. And for an accident/injury case, this ensures the attorney is able to maximize the amount of award for their client, to ensure they are treated properly.”

• Jenkins H, Downie AS, Maher CG, Moloney NA, Magnussen JS, Hancock MJ. Imaging for low back pain: is clinical use consistent with guidelines? A systematic review and meta-analysis [published online January 5, 2018]. Spine Journal. doi: 10.1016/j.spinee.2018.05.004
• Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736–747. doi: 10.1016/S0140-6736(16)30970-9. 
• Goradia D, Linnau KF, Cohen WA, Mirza S, Hallam DK, Blackmore CC. Correlation of MR imaging findings with intraoperative findings after cervical spine trauma. Am J Neuroradiol2007;28:209-15. 

An arthrogram helps your doctor diagnose unexplained shoulder, hip, knee or other joint pain. It can show problems with ligaments, tendons and cartilage with excellent clarity—problems that might not show up on standard imaging like X-ray. It can also help determine the best treatment option for you. If you’ve already had joint replacement surgery, it may be used to evaluate the joint to ensure that it is working properly. 

At Expert MRI, we perform both MR and CT Arthrograms. This simply means that either MRI (magnetic resonance imaging) or CT (computed tomography or “cat scan”) is used to perform the procedure. The one you will have will depend on several factors, including the joint being evaluated and whether or not you are allergic to certain contrast materials.

In either case, the arthrogram enables the joint to be imaged in several positions. Sometimes, a traction device may be used to stretch the joint to allow the radiologist a wider view of the joint. In other cases, items like pillows or sand bags may be used to help position the joint for optimal imaging.

MRI uses a powerful magnetic field, radiofrequency pulses and a computer to produce detailed pictures of soft tissues and bone. It does not use any form of ionizing radiation, like with x-rays. MR arthrography involves the injection of a contrast material called gadolinium into the joint before the test. The contrast material outlines the structures within the joint and allows them to be more easily seen and evaluated by the radiologist. 

CT is an imaging system that revolves around the patient, taking multiple x-rays at different angles. A computer then processes these into cross sectional images of anatomy. Because CT arthrography is X-ray based, a different type of contrast material containing iodine is used.  

Arthrography is particularly effective for detecting tears or lesions of the structures and ligaments of the joints, especially the knee, wrist and elbow, as well as rotator cuff tears or damage from a shoulder dislocation.

If you’ve had unexplained joint pain, an arthrogram could be the test that leads to an accurate diagnosis.

BELLFLOWER, Cal.
ExpertMRI is pleased to announce from November 1, 2019, we have started taking major insurance providers.
Currently, we are accepting insurance plans from these insurance providers.

Health Insurance Provider List

• Careworks (Rockport)
• Conserve Care, Inc.
• Corvel Corporation
• Coventry
• Department of Labor
• Homelink
• Medicare
• MTI – MedComp USA
• OneCall
• Orchid
•  Transparent Health Marketplace, LLC
•  Payers Direct
•  VES Veterans Evaluation Services

The announcement of “accepting major health insurance plans” is a source of patient and healthcare provider assurance to access diagnostic imaging protocols without having to worry about medical bills. However, it is the responsibility of patients to connect with their insurance carrier for further verification of benefits and coverage.

Connect with the ExpertMRI Team to know more about the plan or ask further questions in regards to the recent announcement. Call 877.MRI.8888 or email at info@expertmri.com

About ExpertMRI

ExpertMRI is the leading network of Advance and New MRI Technologies in California – and Experts of Brain, Neck, Spine, Orthopedic, and Litigation Imaging. Located conveniently throughout California – ExpertMRI boasts of 17 Locations.

ExpertMRI diagnostic Imaging Network is also a foremost resource of diverse Front Open, Upright Multi-positional MRI devices with state-of-the-art MRI equipment including High-Field (3T & 1.5T), designed to deliver comfortable, Zero-Radiation Imaging Experience to patients and accommodates patients of all ages, weight and with distinctive diagnostic imaging requirements.

Millennials and those within Generation Z are victims of emerging modern-day diseases. This can be primarily due to one’s lifestyle, especially spending long hours browsing the internet on laptops or smartphones. One of the common disorders among young people is known as Text Neck Syndrome. A U.S. chiropractor coined the term (also known as Turtle Neck Syndrome). Text Neck Syndrome develops because of continuous stress to the normal neck curvature. 

How is Neck Pain Associated With Text Neck Syndrome?

One can experience neck pain due to sustaining an injury, or as a result of remaining in an unnatural or poor posture for a prolonged period of time (e.g. constantly looking downward our mobile devices).

This stress leads to the development of tightness and soreness in our neck and around our shoulders. The more we strain our neck, the higher the level of weight it must be required to carry.

Can an MRI Scan Diagnose Text Neck Syndrome?

Many people are uninformed about the term Text Neck Syndrome. They go by “neck pain,” “inflammation,” or “shoulder stiffness,” etc. When you experience constant pain in your neck or shoulder region, you cannot afford to overlook the symptoms. Your doctor will recommend undergoing an MRI to properly diagnose the issue.

You may require a cervical spine MRI to diagnose or discover the cause of your shoulder or neck pain. A cervical spine MRI scan will produce images of your musculoskeletal system, focusing on the neck and spine region. The scan will detect deformities or defects associated with your pain, including weakness or numbness.

Are Smartphones Causing Neck Pain and Spinal Disorders?

In an upright position, our ears are aligned with the center of our shoulders. When upright, the average weight one’s head can sustain is around nine to 12 pounds. However, when the head is tilted forward (even by only a few inches) the pressure increases dramatically. In fact, as much as 60 pounds is exerted on one’s neck when the chin touches the chest.

Our neck and spinal posture changes as we spend an extended amount of time on our mobile devices. As a result, our neck muscles and shoulders experience or bear excessive tension. This can further exacerbate chronic headaches associated with Text Neck Syndrome.

Overlooking the symptoms of Text Neck Syndrome can cause inflammation in our neck ligaments, nerve irritation, and also lead to an abnormal spinal curvature. Furthermore,Text Neck Syndrome can change the structure of our vertebrae, causing a deformity known as “dowager’s hump.” Sitting slumped for long periods can restrict our lungs’ ability to expand – which is crucial for the flow of oxygen to one’s heart.

Signs and Symptoms of Text Neck Syndrome

Text Neck Syndrome sends innumerable signals through our bodies. The most common type of signal is neck pain or shoulder stiffness. However, you should also lookout for the following signs to access the right treatment process:

• Stiff neck: Difficulty moving one’s neck
• Pain: In the form of a dull ache or a sharp pain occurring in the lower part of the neck
• Radiating pain: Text Neck pain can emerge from our neck and spread to our shoulders and arms.
• Muscle weakness: Our shoulder muscles, like the rhomboid or trapezius and external rotators, are weakened due to constant strain. This often causes muscle weakness.
• Headaches: The tightening of our suboccipital muscles can cause chronic headaches.

Additionally, patients should be aware of the following symptoms:

• Compressed craniocervical joint
• Loss of lung capacity
• Spinal degeneration and early onset of arthritis

If you’re suffering from widespread neck pain, you should immediately visit a physician to receive an accurate diagnosis to remedy the issue.

Cervical Spine MRI for Neck Pain or Text Neck Syndrome

Your physician will prescribe an MRI scan to detect the cause of your neck or shoulder pain and each a precise diagnosis.

An MRI scan is a non-invasive, radiation-free imaging tool providing doctors with concrete evidence about a suspected condition. Using powerful magnets, radio waves, and computer programs, detailed images of bones, organs, muscles, ligaments, and tendons are produced to diagnose a disease (or to see how well a patient is responding to the treatment process). MRI scans can help detect minute tensions, strains, or sprains that are often missed in X-rays or CT Scans.

When a doctor suspects Text Neck Syndrome and recommends an MRI, check with your insurance provider to see if the procedure is covered. In many cases, the procedure is covered, but the disorder might be under a different name or terminology.

Advanced MRI Technology to Detect Text Neck Syndrome – Upright MRI

The Upright MRI system is a state-of-the-art MRI technology that scans patients in multi-positional and symptom-specific positions. It is also called ‘weight-bearing,’ ‘positional’ or ‘Stand-Up MRI.’

The technology and design of the Upright MRI system allows for us to scan patients in diverse positions, including the exact position where a patient is experiencing the pain. An Upright or Stand-Up MRI is used to measure the precise weight displacement on the craniocervical junction, or any other joint within the body.

An Upright MRI system is recommended to patients suffering from Text Neck Syndrome or general neck pain. It not only provides high-field MRI scans, but also takes images in different postures to show where the actual problem exists.

Expert MRI also provides combination Front Open & Stand-Up MRI scans for patients. This is a perfect option for patients who have claustrophobia or anxiety. Our advanced machines can accommodate patients of larger size, children, senior citizens, or patients with disabilities.

People suspected of suffering from Text Neck Syndrome can receive a Front Open/Stand-Up MRI from your local Expert MRI location. A scan will allow patients to see exactly where their neck pain originates from, and also have subspecialty radiologists provide a complete diagnostic report about any injury or stress to the craniocervical junction.

Preventing Text Neck Syndrome

Preventing any disease is always advisable. While it is not possible for most of us to entirely stop using smartphones or handheld devices, there are ways to prevent the syndrome from progressing. Some tips for preventing Text Neck Syndrome include:

• Avoid prolonged static positions
• Avoid excess use of smartphones (and take frequent breaks)
• Position your device at eye level (rather than chest level) to reduce stress on the head and neck
• Avoid repetitive movements like continuous typing or swiping
• Avoid holding a bulky device in one hand for long durations
• Try practicing yoga to prevent neck pain resulting from mobile phone use – exercises like the exaggerated nod, cat-cow, or bow-pose can help reduce stress on the head and neck.

If you do experience prolonged pain, it is best to receive a thorough examination by a qualified Expert MRI physician.

Think You Might Have Text Neck Syndrome?

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Published by Consumer Attorneys Association of Los Angeles

MRI OF THE CRANIO-VERTEBRAL JUNCTION: A VALUABLE TOOL TO EVALUATE “WHIPLASH”

Presenters

Sana U. Khan, M.D., Ph.D. is a radiologist and neurophysiologist affiliated with Expert MRI. Expert MRI has diagnostic imaging offices throughout Southern California. He is a Phi Beta Kappa graduate of UC Irvine and received his medical training at UCLA Medical School.

Technical Requirements

Click here to download the Advocate Article.

Magnetic Resonance Imaging (MRI) is a noninvasive and radiation-free medical test conducted by physicians to look inside the human body. MRIs use powerful magnetic fields and radio signals to produce an image of the targeted body part. With review by a specially trained radiologist, images produced by an MRI can provide clear indicators of why the patient was having certain symptoms and lead to proper treatment.

The initial design of MRIs was tunnel-like where patients would lay down in a circular, enclosed tube.  Due to a large number of patients experiencing claustrophobia and a “sensation of being buried,” MRI manufacturers produced machines designed with magnets placed above and below with the sides open.  These machines are commonly known as “open MRIs.”  However, patients are still lying down with a very heavy magnet inches from their face and even though these machines do decrease the “buried” effect, many patients continued to complain of claustrophobia.

It is a simple, yet fundamental observation that many human musculoskeletal conditions are impacted by gravity, and that many patients experience signs and symptoms in weight bearing positions even when they do not in the recumbent one.  Conventional magnetic resonance imaging systems are limited to acquiring scans with patients in the recumbent position. Thus, recumbent imaging alone may not demonstrate the full degree of pathology, due to muscle and ligament relaxation and in the case of the spine, disc retraction.  Smith et al. (2006) performed a study on 25 patients with low back pain and sciatica.  These patients were referred for lumbar spine MRIs following at least one prior “normal” recumbent MRI within 6 months of referral. In this study, 13 patients demonstrated abnormalities in one or more of the seated postures that was not evident in the supine positioned MRI.  That’s a 52% missed rate.  Would you send a loved one to do mammography on a machine that missed pathology 52% of the time?

Positional MRI is a continued evolution in the design of this technology.  The magnets are vertically placed on the sides which results in a front open design virtually eliminating any claustrophobia as patients can watch television while the MRI exam is being performed.  From a medical perspective, a major advantage emerged from this front and top open design.  Patients can actually be placed in varying positions rather than “supine only” which is the limitation with other MRIs.  Unlike the traditional MRIs where the patient only had their injury imaged in a relaxed state while lying down, the Positional MRI system allows upright, angled (slanted) and recumbent imaging, replicating partial or full weight bearing conditions.  It also allows kinetic maneuvers of the patient’s whole body or any body part which results in images acquired in position of normal everyday stress, across the limits of normal range of motion. Most importantly, imaging is performed in the specific position of the patient’s clinical symptomatology.