Images Of Healing
October 29, 2009
The other day, while reviewing the many emails that
my subscribers sent me, I came across one that posed
an interesting question. This person had a painful
knee that had undergine prior surgery, leaving the
woman with a screw and a stap-le in her knee.
The issue was that she now has knee pain. She
suspects that she may have a torn meniscus (one of
the semi-lunar cartilages, inside the knee joint),
based on the symptoms and signs that have been
elicited. Joint line pain, painful snapping,
giving way, when descending stairs, and other signs
of instability are all suggestive of this problem.
I discuss these in greater detail (as well as the
reasons why they manifest like this) in my
LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN
http://www.drbillsclinic.com/eliminate_knee_pain.html
She wanted to know if any type of medical imaging
could tell her if this really was the source of her
pain, or if there was another problem. She had been
told, however, that the metal within her knee would
prevent her from getting an MRI or a CT scan.
I suggested that since this metal was now
non-functional, the trauma for which they had
been inserted, now long healed, why not remove the
metal under local anesthesia? Then, you could go
ahead with the scan of your choice.
However, it occurred to me that many of my readers
may not really understand the differences between
all the options for the images of healing available,
today. So here and now I’ll give you a brief
description of each.
CT or CAT Scan stands for Computerized Tomography,
or Computer Assisted Tomography. This uses a pencil
thin beam of radiation (x-rays), usually in a spiral
pattern to image part of the body. The multiple
image “slices” are read by the computer and may
even be assembled into 3-D images. It is best for
evaluating the bones, in great detail. And it is a
very fast test, usually less than five minutes.
Metal can cause the beam of x-rays to ricochet in
“scatter” patterns, which obscured the images with
earlier machines. Recent advances in software,
however, minimize this scatter, and metal is no
longer an absolute contra-indication.
An MRI Scan does NOT use radiation, but rather a
pulsing, extremely strong magnetic field. This field
pulls the electrons out of their orbits around hydrogen
atoms in our tissues. When these electrons fall back
to their former postions, they emit radio signals.
The computer assembles these signals into very fine
detailed images.
MRI’s are best for soft tissues. Because they use
magnetism, they take longer to do, usually 30-45
minutes. The rapidly alternating magnetic fields
make a loud sound, like a machine gun. They are
also VERY sensitive to metal implants, which warp
the magnetic field, even if the metal is non-ferrous
(ie. not iron based, or magnetic). This produces
a black blob on the image, in the region of the metal.
A Nuclear Scan is done by injecting a radioactive
isotope, specific for the tissue you want to examine,
intravenously. For example, Technetium 99 has an
affinity for bone, so it’s used for bone scans. In
such scans, the body itself becomes mildly radioactive,
for a brief period of time. Cellular activity is
demonstrated by increased radioactivity, which is
“read” by a crystal and assembled into images. The
“blacker” the image, ie., the more radioactivity,
the more activity. This is used by physicians to
evaluate fractures, infections, metabolic disease,
tumors, etc.
An Arthrogram is a plain x-ray of a joint, into which
an iodine based “dye” (which stops x-rays) and air are
injected. The dye “paints” the internal structures,
visualizing the normally invisible, together
with any abnormalities that may be present.
Using one or more of these images of healing, the
physician can correlate the resultant findings with
the physical exam, signs and symptoms to confirm or
refute his presumptive diagnosis.
Many people are afraid to even go to see a doctor,
for fear that he or she will “make” them have surgery.
No one can “make” you do anything. It’s always a good
idea to KNOW what you’re dealing with. With that
knowledge, you then have a range of options for
treatment.
There are times when surgery IS appropriate.
But many, or even most times, any of a variety of
conventional and alternative treatments may relieve
your pain, WITHOUT surgery. That’s the reason I wrote
my healing program, HOW TO AVOID KNEE SURGERY
http://www.drbillsclinic.com/avoid_knee_surgery.html
to give you all your options. So, next time you get
injured, or develop some pain in your joints, get a
thorough medical evaluation, so you can obtain ALL
the information you can get. Only then can you make
a wise decision about treatment options. It’s what
you DON’T know that can hurt you.
I hope this brief review of applied radiology will
be helpful to you. Til next time, my friend, be well.
Yours for a pain-free tomorrow,
Dr. Bill
