Do I need a scan? MRI or X-ray? And how do I get one?
These are a couple of questions we hear most days in clinic. If we feel we need an X-ray or MRI scan to help diagnosis and management of your case, there are a few options available to you. If it is urgent, for example, we suspected you have a broken bone, we would send you straight to A&E with a cover letter, this happens a handful of times a year in each clinic. More commonly, we might like an X-ray or MRI but it be less urgent in nature in which case we write to your GP to request a referral. This can be slow via the NHS depending on the symptoms. There are options to go privately, our usual MRI clinic in Bristol charges around £400 currently and this is something we would discuss with you.
X-rays show up things going on with bone; Breaks and fractures, tumours, osteoarthritis etc. MRI’S show these things too but also show up what is happening in the soft tissues (ligaments, tendons, muscles). So in general if we have reason to believe there any bony pathologies like fractures, tumours or arthritis an X-ray might be of use. MRI’s show more detail and also show the soft tissue, so might be more appropriate in some cases. Another factor to consider is that a scan might only be required if the result of the scan would change management, treatment and outcome for you.
In the case of disc bulges, aka slipped or protruding disc, only SOMETIMES is a scan required. Very many of us have a slipped disc, many of us with no symptoms at all. Most get better with treatment and conservative management and time. The symptoms of a bulge can be wide and varied and only the more serious symptoms would we usually recommend a scan, for example muscle weakness. The most extreme 1-5% of disc bulges require surgery and of course these cases would have needed scans first.
Another common example might be hip or knee arthritis. If the symptoms and presentation all indicate it is arthritis, and it is responding well to treatment, and it is not so severe that surgery is a current consideration, then it might not yet be worthwhile having a scan. As the result may not change anything from a treatment and outcome perspective.
All cases are unique and individual. The presenting symptoms, case history and examination all together help us know if a scan is required. If you have any concerns about needing a scan please discuss with your practitioner or GP.