Understanding Medical Tests with Dr. Jason Tarno

Often when an athlete is injured certain tests are performed. Can you discuss some common medical tests for sports related injuries?

Of course every injury is different, and many disorders can be diagnosed in the office with a good history of the problem and good physical exam. Most orthopedic injuries require an x-ray as an initial screening for injury to the bone. Broken bones or fractures can be diagnosed most often with a simple x-ray. Sometimes it is difficult to diagnose the injury with an x-ray and further testing is needed. Tests such as MRI, CAT scan, and bone scans have been developed, which aid the physician greatly in making an accurate diagnosis, which helps the physician direct proper treatment.

If an x-ray looks mostly at the bone why do physicians order an x-ray with injuries that seem to be strains of ligaments or muscles?

While the common x-ray has lost its luster in the last 20 years with the popularity of MRI and CAT scans, a great deal of information can still be gleamed from a radiograph, or x-ray. Fractures and dislocations are seen very well. Sometimes an injury that seems like it is a soft tissue injury such as a sprain or strain actually involves an avulsion fracture of bone where the tendon attached.

What is worse, a fracture or a broken bone?

Both terms mean the same thing. Physicians typically use the term fracture to refer to a broken bone because it is the proper term in the medical literature.

What is an MRI?

MRI stands for Magnetic Resonance Imaging. This is a special test that uses a large magnet and computer to process information into a picture of the bones and soft tissues. Several pictures are taken of the injured body part in three different views, each about 1-2 mm apart. This test has become one of the most commonly ordered tests in sports medicine for soft tissue injuries such as ligament, tendon, and cartilage tears.

Is this the test that makes someone lay in a tunnel?

In some cases the patient lies on a flat bed that moves into a circular structure, which then takes the images. Some people that are claustrophobic often select an “open MRI” in which the tube that the patient goes into is open on each end. Crovetti Orthopaedics and Sports Medicine offers an open MRI for our patients. A typical scan requires about 30-45 minutes to perform.

How is a MRI different from a CAT scan?

A CAT scan is a Computed Automated Tomography scan and is similar to a MRI in that several pictures are taken of the injured body part. The CAT or CT scan does not use magnetic energy, however, and is therefore the desired test for anyone with metal such as a pacemaker. CT looks at bone better than MRI; however, the MRI looks at the soft tissues much better than the CT scan.

What is a bone scan?

This is a test in which an IV is started and the patient is administered a type of contrast material that collects in areas of high bone turnover such as a fracture, bone infection, or bone tumor. In athletes this test is often used to rule out a stress fracture.

It seems like surgeons and physicians have a lot of good tools at their disposal in order to diagnose athletic injuries.

That is true. However, no matter what test is used, it should never take the place of a good history and physical exam.

- Jason M. Tarno, D.O., is Board Certified and Fellowship trained in Sports Medicine. Dr. Tarno is an associate of Crovetti Orthopaedics and Sports Medicine.

For further information call: 990-2290.

Or visit us at: www.CrovettiOrtho.com