MRI Is Best For Constant Numbness & Tingling In Hands or Arms
When you have a disc herniation in your neck that is pressing on a nerve, you have numbness and tingling in your hands or arms all day and night. If you have constant numbness & tinglings (pins & needles feeling) in your hands or arms after a car or motorcycle accident that lasts more than one month, you should have an MRI test on your neck. The key word is "Constant" which means that you have the numbness and tingling all day long and it doesn't matter what position your neck is in. This is generally not the correct test if your symptoms are intermittent or occasional.
Stress X-rays Best for Intermittent or Occasional Numbness & Tingling In Hands or Arms
Intermittent or occasional numbness & tingling in your hands or arms after a motor vehicle accident is usually NOT a disc herniation. Thus, if your doctor orders an MRI, it is often "negative" which means they do not find a disc herniation large enough to press on a nerve. The proper tests with these symptoms are Stress X-Ray films or Digital Motion X-Ray/Fluoroscopy. Stress x-ray films are inexpensive and are generally done as part of the standard Davis 7 view neck x-ray study done on trauma patients. A proper reading of these films to look for breaks in Georges's Line on the flexion and extension films will show whether there has been a partial ligament tear/rupture. Ligament partial rupture causes translation instability (extra motion and instability of the joint.) When any neck joint is unstable, movement of the neck causes pain and intermittent numbness & tingling WITH NECK MOVEMENT. Digital Motion X-ray/Fluoroscopy should be done if plain x-rays find any ligament rupture.
MRI for the Lower Spine/Low Back?
The same rules apply for which test is most appropriate for radiating pain, numbness, or tingling in your legs or feet. Get an MRI test if your symptoms are constant and there all day and night. Get stress x-ray films taken and/or Digitial Motion X-ray/Fluoroscopy if the leg symptoms come and go during the day.
All Radiologists Are NOT Equal - Get A Second Opinion Reading for MRI & X-Ray Films
MRI films and X-ray films must be "read" by a doctor experienced in that field. Unfortunately, health insurance companies these days pay radiologists so little to "read" and interpret these films that the radiologist often spends only 30-60 SECONDS reading all the films in the study and dictating the report. Most pathology is not mentioned because the radiologist doesn't have time to dictate a proper report and still make enough money that day to pay the overhead. So-called "negative" studies frequently have information on the films that was ignored or overlooked by the radiologist in a hurry. It is well worth it to have a second opinion reading by another radiologist when the symptoms persist and there is a "negative" report. The last time I did this for a client, my radiologist's report described the torn biceps tendon that the first radiologist had written was "normal" six months earlier. Sadly, the delay from a bad report caused this client to have much more extensive surgery
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