Dr. Bakthaprabhudas N (P.T.)

Gone are the days when bone ailments and damages were detected based on the experience and superficial conversations made by the physicians. These days with the advent of radio waves, medical science has made significant progress that has enabled a detailed overview of what exactly is going on inside your body and what should be the most relevant treatment in that regard. Magnetic Resonance Imaging or more commonly known as MRIs are a boon when it comes to diagnosing orthopedic and musculoskeletal complaints.

Common Uses of the Procedure:

MR imaging is usually the best choice for examining the:

1. body’s major joints.
2. spine for back pain
3. soft tissues (muscles, tendons and ligaments) and bones of the extremities.

MR imaging is typically performed to diagnose or evaluate:

• degenerative joint disorders such as arthritis.
• tears of the menisci, ligaments and tendons (knee) or rotator cuff and labrum (shoulder and hip).
• fractures (in selected patients).
• spinal disk abnormalities (such as a herniated disk).
• the integrity of the spinal cord after trauma.
• sports-related injuries and work-related disorders caused by repeated strain, vibration or forceful impact.
• infections (such as osteomyelitis).
• tumors (primary tumors and metastases) involving soft tissues around the joints and extremities (such as muscles, bones and joints).
• pain, swelling or bleeding in the tissues in and around the joints and extremities.
• congenital malformations of the extremities in children and infants.
• developmental abnormalities of the extremities in children and infants.
• congenital and idiopathic (developing during adolescence) scoliosis prior to surgery.
• tethered spinal cord (abnormal stretching in the spinal cord) in infants and children.

The Process:

In this process, X-rays and radio waves are subjected upon the affected region to examine the conditions of the bones, tissues, muscles and also detect the presence of tumours. This is majorly a non-invasive test and is painless. It does not use ionizing rays and therefore does not harm the body in any which way. The MRIs capture a detailed picture of the organs and the internal body structures and then transmit them onto a computer screen for the physician to monitor the inside story.

The Benefits: 

1. MRI is an imaging technique that does not require exposure to radiation.
2. MR images of the soft-tissue structures of the body (particularly muscles, bones and joints) are often clearer and more detailed than with other imaging methods. This detail makes MRI an invaluable tool in early diagnosis and evaluation of many conditions, including tumors.
3. MRI can distinguish abnormal tissues from normal tissues much more accurately than most other imaging tests (x-ray, CT, etc.).
4. MRI enables the discovery of abnormalities that might be obscured by bone with other imaging methods.
5. The contrast material used in MRI exams is less likely to produce an allergic reaction than the iodine-based contrast materials used for conventional x-rays and CT scanning.
6. MR images allow the physician to clearly see even very small tears and injuries to tendons, ligaments and muscles and some fractures that cannot be seen on x-rays and CT. If you wish to discuss about any specific problem, you can consult a radiologist.

Shoulder pain while lifting overhead objects might be a result of strenuous activity involving tendons impinging bones of the shoulder. Impingement syndrome is also called swimmer’s syndrome.

What causes it?
It is caused by activities involving tendons and bones of the shoulder, for example strenuous activities, such as swimming, tennis and gym activities involving muscles of the shoulder. Even reaching for overhead objects and painting might aggravate impingement syndrome. If not treated at the right time, the syndrome might become extremely painful as the tendons begin to tear.

Symptoms
General pain in the shoulder is one of the most common symptoms, especially while reaching for overhead objects or using shoulder and arm muscles in general. If it occurs for a prolonged period of time, then it might actually lead to a tendon tearing and leading to a rotator cuff tear. This would overtime lead to decreased ability to use the arm muscles and the bicep muscles might tear as a result of prolonged negligence, despite swimmers syndrome. A doctor would recommend a physical exam and x-ray to rule out possibilities for bone abnormalities and arthritis.

How to prevent and treat it? 
Those who have extreme shoulder pain and have been diagnosed with swimmer’s shoulder are referred to a physiotherapist with whom, regular sessions help restore mobility of the affected areas. The physiotherapist recommends the patient numerous stretching exercises to practise, preferably under a hot shower. In addition to physiotherapy, a doctor will prescribe powerful painkillers which have to be administered orally on a regular basis. 

These oral painkillers, such as ibuprofen have to be taken under the guidance and prescription of a doctor as they will have a host of side effects such as acidity and should be taken post meals. In case of ineffectiveness of orally administered painkillers, cortisone based injections might be given, but it is a double-edged sword as the effectiveness of these injections decrease over time and it might make the muscles and tendons weak. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.