what to order

Spine

MR P
referred 

  • Disc herniation Primary neoplasm 
  • Suspected metastatic neoplasm
  • Trauma with associated myelopathy
  • Other indications of myelopathy
  • Discitis
  • Congenital Anomalies
  • Stenosis 

CT Preferred

  • Disc disease when MR is contraindicated
  • Bony trauma
  • Fine bony detail (facet joints and other)
  • Stenosis (MR or CT)
  • Congenital anomalies
  • May be used in conjunction with MR with or without contrast
  • Linear tomography good for C1-2 and odontoid process
  • CT Myelography may be used where MRI is contraindicated 

 Bone Scan

Most sensitive for detecting fracture, primary or secondary neoplasm (excluding multiple myeloma) infection and other selected cases. However, less specific modality. Always send conventional films and medical history

Temporomandibular joints

MR Preferred

  • Internal derangement
  • Avascular Necrosis
  • Arthropathy & Adhesion
  • Masses

CT or Polytomography Preferred

  • Congenital Bone Dysplasia                
  • Fracture
  • Arthropathy

Extremites

 MR Preferred

  • Avascular necrosis
  • Primary and metastatic tumors
  • Osteomyelitis and septic arthritis
  • Occult joint effusion
  • Tendon and ligament injuries including rotator cuff tears
  • Shoulder impingement syndrome
  • Shoulder labrale disease
  • Traumatic injury to articulation
  • Meniscal tears, ligament injury to knee
  • All soft tissue masses
  • Primary synovial disease
  • Carpal tunnel disease
  • Triangular fibrocartilage tear of wrist

  CT Preferred          

  • Evaluation of fractures
  • Indeterminate bone lesions on MRI
  • Conventional films or bone scintigraphy

Bone Scan

  • For screening to rule out mets. Used in conjunction with MRI, 
  • CT and conventional films for fracture, neoplasm and infection. 

 

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