Magnetic resonance imaging (MRI) is an advanced imaging technique that uses radio waves, a strong magnetic field, and a computer to create clear and explicit pictures of joints, bones, and soft tissues. MRI is an ideal imaging technique while evaluating the body for tumors, injuries, and other degenerative disorders. If you are to undergo a musculoskeletal MRI, you should ensure that you inform the doctor about all your health problems, allergies, recent surgeries, and if there is a chance that you are pregnant. An MRI procedure is safe but requires caution if you have devices like pacemakers and other metallic devices because it may cause them to malfunction. If you need reliable MRI services, you can count on Los Angeles Diagnostics.
Understanding An MRI of the Musculoskeletal System
An MRI of the musculoskeletal system is effective in diagnosing a wide range of medical conditions. This non–invasive procedure uses radio waves, a strong electromagnetic field, and a computer to provide clear pictures of internal structures. Unlike X –rays, an MRI does not use radiation. The detailed MRI images enable doctors to examine the musculoskeletal system and detect disease. The doctors often review the images on a computer screen. The images can also be copied or printed on a CD, transmitted electronically, or uploaded to a digital cloud server. MRI is an ideal procedure for examining problems in the:
- Spine if you often experience back pain
- Major joints
- Soft tissues, including tendons, muscles, and ligaments
A musculoskeletal MRI can be performed to evaluate and diagnose the following conditions:
- Joint disorders, including degenerative joint disease and arthritis
- Tears of the ligaments, menisci, knee tendons, rotator cuffs, and labrum
- Evaluating fractures in certain patients
- Examining abnormalities in the spinal cord disk, including a herniated disk
- Evaluating the integrity of the spinal cord after trauma
- Assessing the extent of work-related and sports-related injuries and disorders that result from repeated strain, forceful impact, and vibration
- Examining infections like osteomyelitis
- Tumors including metastases and primary tumors involving soft tissues in the extremities and joints
- Diagnosing swelling, pain, and bleeding in the tissues that are around the joints and extremities ( such as bones, muscles, and joints)
- Developmental abnormalities in children and infants, especially in the extremities
- Congenital malfunctions of the extremities in infants and children
- Congenital and idiopathic scoliosis before surgery
- Abnormal stretching of the spinal cord (tethered spinal cord) in infants and children
Preparing For A Musculoskeletal MRI
While undergoing an MRI of the musculoskeletal system, you will be required to wear a hospital gown. However, you can remain in your clothing as long as the clothing does not have metal fasteners and is loose-fitting. Guidelines regarding what you should eat or drink before the MRI procedure varies between specific facilities and exams. You should take food and medication as usual unless the doctor advises you otherwise. In some instances, the MRI technician will need to use contrast material to get more explicit images.
The technologist may ask you whether you are allergic to iodine contrast material, certain drugs, foods, and environments. Most MRI examinations use a contrast material known as gadolinium. If you have an iodine contrast allergy, gadolinium contrast will be the ideal option. Many patients are less likely to react to gadolinium contrast material compared to iodine contrast. Even if you are allergic to the gadolinium contrast, the MRI technologist can still use it after an appropriate premedication.
Before you undergo a musculoskeletal MRI, you should ensure that you inform the technologist if you have a severe health problem or you have recently undergone surgery. The technologist may have to use unique forms of gadolinium contrast if a patient has certain medical conditions like severe kidney disease. You may have to undergo a blood test before the MRI procedure to determine whether your kidneys function correctly. For women, it is always advisable to inform the doctor if there is a chance that you might be pregnant.
Since the 1980s, MRI has been performed on pregnant women, with no evidence of adverse effects on them or their unborn babies. However, the baby will be subjected to a strong magnetic field. Therefore, unless the benefits of the MRI test outweigh the potential risks, a pregnant woman should avoid undergoing an MRI exam in the first trimester. Likewise, unless it is unnecessary, a pregnant woman should not be subjected to gadolinium contrast.
You may request that your doctor or the MRI technologist provide a mild sedative if you have anxiety or fear of enclosed spaces, usually known as claustrophobia. In small children and infants, anesthesia might be necessary to enable them to undergo the exam without moving. Whether or not sedation or anesthesia is needed will vary depending on the child's age, type of examination, and intellectual development. To ensure the child's safety, an expert in pediatric anesthesia or sedation should be present. You will be advised in advance on how to prepare your child.
Some MRI facilities have a particular person to work with children during the procedure. This personnel may eliminate the need for anesthesia or sedation. They will prepare a child for the process by showing a dummy MRI scanner and playing noises that the child will hear during the MRI exam. They will also explain the procedure and answer all questions to help relieve anxiety. In addition, some MRI facilities provide special headsets and goggles to allow children to watch movies and listen to music as they undergo the scan. Keeping the child occupied with movies or music enables them to remain still, allowing good image qualities.
Jewelry And Accessories
If you are scheduled to undergo an MRI examination, you should ensure that you leave all the jewelry and accessories at home or remove them before undergoing the MRI procedure. Electronic and metallic items may interfere with the magnetic fields of the MRI scanner, thus are not allowed in the MRI room. These objects also become harmful projectiles or cause burns in the MRI room. Items that you should not carry into the MRI include:
- Watches, jewelry, hearing aids, credit cards because could be damaged
- Avoid carrying hairpins, pins, metal zippers, and other metallic items because these could distort and compromise the quality of MRI images
- Leave all removable dental work behind
- Avoid carrying pocket knives, pens, and eyeglasses
- Body piercings
- Leave behind your electronic watches, mobile phones, and tracking devices
MRI In Patients With Metal Implants
If you have a metal implant, you might be wondering if you can undergo an MRI scan. In most cases, MRI scans are safe in patients with metal implants except for a few types of implants. Therefore, you should only undergo an MRI scan or enter the scanning area after a thorough safety evaluation. The implants include:
- Ear or cochlear implants
- Certain types of clips, commonly used for brain aneurysms
- Some older pacemakers and cardiac defibrillators
- Certain types of metal coils that are placed within blood vessels
You should inform the MRI technologist if you have electronic devices or medical devices in your body. These devices could pose a risk or interfere with the MRI exam. For example, many metal implants and devices have an accompanying pamphlet explaining the device's MRI risks. If you have such pamphlets, you should bring them to the MRI technologist before undergoing the scan. The technologist cannot perform an MRI exam without first documenting or confirming the type of implant a patient has and its MRI compatibility. The pamphlets are essential because they contain detailed information to help address any questions and concerns the MRI technologist may have.
If you are not sure about the specific metal objects present in your body, an X-ray exam can help reveal these objects. Most metal objects that doctors use during orthopedic surgery do not pose any risk during an MRI exam. However, you may have to undergo another type of imaging if you have a recently placed artificial joint.
Foreign Objects In the Body
If you have foreign objects like bullets, shrapnel, or other metal objects, you should ensure that you inform your doctor. It is imperative to disclose any metal objects that could be lodged in your eyes because these might move during an MRI scan and lead to blindness.
If you have tattoos, the dyes in the tattoo might heat up during the scan, especially if they contain iron, but this is rare. Braces, tooth fillings, eye shadows, and other cosmetics are often not affected by an MRI. However, these objects might distort the MRI images, especially if you are undergoing an MRI scan around the facial area. If you accompany a patient to the MRI room, you must undergo screening for metallic objects in your body.
How An MRI Procedure Works
Unlike an X-ray or a CT (computed tomography) scan, an MRI procedure does not involve using radiation. Instead, an MRI produces radio waves that realign the hydrogen atoms that are present in the body. As the hydrogen atoms go back to the usual alignment in the body, they emit different energy levels, depending on the body tissue being examined. The realignment of radio waves does not cause any changes in the tissues. The MRI scanner captures the energy emitted by the hydrogen atoms and creates a picture using the information.
MRI scanners contain coils within the machine; a magnetic field is produced when an electric current passes through these wire coils. Some coils are placed around the body part being examined. These coils send and receive radio waves and produce signals that are detected by the MRI machine. This electric current doesn’t come into contact with the patient. As the computer processes the electric signals, it produces numerous images of small portions of the body. The radiologist examines and studies these images from different angles. Compared to CT scans and X–rays, an MRI scan produces a clearer distinction between healthy and diseased tissue. It also creates a higher quality image than an ultrasound.
Performing An MRI Procedure
Usually, an MRI scan is performed on an outpatient basis. The MRI technologist positions the patient on a moveable table. The technologist may use bolsters and straps to help the patient maintain their position. In addition, the technologist may place specific devices capable of sending the sending radio waves next to or around the body area being examined. The scan involves several scans or sequences, some that may last for minutes. If the technologist uses a contrast material, they insert an IV line (intravenous catheter) into the patient's vein on the arm or hand and use it to inject the contrast material.
The patient is placed within a magnet in the MRI unit. While performing the MRI exam, the technologist will also be working on a computer screen in another room. If the technologist uses a contrast material, they will take a series of images before the injection of contrast material and then take additional images after injecting the contrast material. After the MRI exam, the patient will wait as the radiologist examines the images and determine if more images are needed. The radiologist or MRI technologist will remove the IV line once the MRI exam is complete. The entire MRI examination typically takes between thirty and forty-five minutes. If the patient is to undergo sedation, the sedation may add between 15 and thirty minutes to the MRI procedure. The patient may have to come in earlier to be examined before the MRI procedure. The patient may need to stay a little longer after the MRI procedure to allow the sedation to wear off while being closely monitored.
What To Expect After An MRI Procedure
MRI examinations are usually painless, even if some patients often find it hard to remain still. Some patients, those with claustrophobia, might feel anxious and enclosed while in the MRI scanner. In addition, the scanner produces some noise during the examination. In some patients, sedation might be necessary to keep them calm. However, sedation is only required for around 20% of patients who undergo MRI. The body part being examined might feel warm, but this is normal. You should inform the radiologist or the technologist if this heat or warmth bothers you. While the radiologist is taking the images, you must remain still.
An imaging sequence lasts between several seconds and minutes at a time. You will hear loud tapping and thumping sounds while the images are being recorded. Patients are often provided with headphones or earplugs to reduce the noise produced by the MRI scanner. Between imaging sequences, you will relax, but the radiologist will request you to maintain the same position without moving to avoid compromising the image quality.
The patient is usually alone in the exam room, but the MRI technologist will see, hear, and speak to the patient throughout the procedure. Most MRI facilities will allow a friend or a family member to be in the MRI room with the patient, but only if they are screened for safety. In some instances, the technologist may inject the contrast material before obtaining the images.
The patient may experience some discomfort and bruise due to the IV needle. There is also a slight risk of skin irritation at the IV tube insertion tube. After the contrast material injection, some patients may experience a temporary metallic taste in their mouth. No recovery period is needed if a patient does not require sedation.
A patient may resume their regular diet and usual activities immediately after the MRI examination. Some patients may experience mild side effects from the contrast material, but this is rare. The typical side effects of contrast material may include headache, nausea, and pain at the injection site. On rare occasions, patients may experience hives, itchy eyes, or other reactions. If you develop allergic reactions after an MRI exam, you should inform the technologist to receive immediate medical assistance.
Benefits and Risks of MRI Exams
The benefits of an MRI exam outweigh the risks. The specific benefits of an MRI exam include:
- MRI exam does not require exposure to radiation
- MRI exams produce more explicit images of the body tissues, bones, and muscles than other imaging techniques like X-ray, ultrasound, and CT scans. This feature makes MRI an ideal imaging technique for the diagnosis of numerous medical conditions and tumors.
- An MRI is more accurate in distinguishing between healthy and diseased tissue compared to other imaging procedures.
- MRI scans are effective in detecting abnormalities that are obscured by bone, which would be hard to see using other imaging techniques
- The gadolinium contrast material, commonly used in MRI scans, is less likely to cause allergic reactions compared to contrast materials used in CT scanning and X-ray.
- MRI scans enable doctors to detect even small tears and injuries on the ligaments, tendons, and muscles, which would be hard to see on CT scan and X-ray
The risks of MRI scans are limited, and the procedure poses no risk to the patient when the proper safety guidelines are followed. The potential risks are:
- In case sedation is used, there is a risk of administering too much sedation.
- The strong magnetic fields might cause implanted devices to malfunction
- There is a slight risk of nephrogenic systemic fibrosis, which is a rare complication related to gadolinium injection
- When a contrast material is used, there is a small risk of an allergic reaction
- When a contrast material is injected into the joint, there is a little risk of pain, infection, and bleeding
- After administering a contrast material, breastfeeding mothers are advised not to breastfeed for 24 to 48 hours.
Find Reliable MRI Services Near Me
If you are scheduled to undergo an MRI, you should find a reliable MRI facility for the best results. For many years, Los Angeles Diagnostics has been providing quality MRI services. You, too, can benefit from our proven imaging services. Call us at 323-486-7502 and speak to one of our radiologists.
