Time to take an X-ray?

The appropriate time for X-ray and other imaging such as MRI and CT scan is debatable. MRI and CT scan being more expensive (minimum of $800 for MRI), are a lot harder to get done. There is about a 4 months wait list in Canada to get an MRI of your knee for a suspected tear, but if you know someone that knows someone in a hospital, you might be able to get it done in about 2 weeks!

Before going into details, let’s answer a very common question regarding the differences between X-ray, MRI and CT.

For the sake of simplicity, X-ray is good to see bones (fractures), MRI is good to see soft tissues such as muscles, discs (disc herniation), nerves and CT scan is good to see structures such as lungs, sinuses, abdomen and heart. Again, it is not as simple as I explained above, your doctor will ask for a specific imaging based on what he or she would like to see!

Ankle (CT Scan)

Ankle (MRI)

Ankle (X-ray)

So when is a good time to take an X-ray? Rule #1, TRAUMA! A trauma can be a fall, a hit or any impact to your body. For example, if an object falls on your toe, depending on the object, there can be pain, swelling, bruising and potentially a fracture! Rule #2, weight bearing is hell! You cannot support the weight of your body on the injured limb. Rule #3, usually with broken bones, the pain will not get better and sometimes it will potentially get worst even with treatments. Rule #4, you are suffering from some sort of bone disease (metabolic disease) such as Osteoporosis.

Summary:

1.       Trauma

2.       Cannot stand on it

3.       Getting worst or staying the same

4.       Underlying bone diseases such as Osteoporosis

True Case at the clinic:

63 years old female comes in the clinic with rib pain after coughing. The pain is not going away. She has a history of Osteoporosis. She was diagnosed after taking x-ray with rib fracture! YES! A fracture with just coughing! So please talk to your doctor.       

Dr. Ali Masoumi

www.facebook.com/drmasoumi

Headaches Suck!

Headaches suck! For the sake of this blog, let’s start with one fact, not all headaches are Migraine Headaches. Yes, they are a common type of headaches and yes, they are very commonly diagnosed. Here are some signs and symptoms doctors use to diagnose you with a Migraine headache:

• ·         Pain in usually on one side of the head

• ·         Sensitivity to light and/or sound

• ·         Nausea and/or vomiting

• ·         May have aura (perception of a strange light, an unpleasant smell or confusing thoughts before the actual headache)

You may experience slight variations of these signs and symptoms, and you may have tried different types of medications with little or no results, which denotes to the debatable lack of understanding in the origin and cause of this disease.

Other common examples of headaches are Cluster Headaches, Frontal Headaches (usually due to sinusitis) and Suboccipital headaches. These are just few examples of headaches classified by the International Headache Society (IHS), which has a good website for more information. (Google it!)

The type of headache I really want you to be familiar with is Suboccipital headaches, which I commonly see in my practice. I have had many patients wrongfully diagnosed with Migraine whom suffer from Suboccipital headaches who got significantly better after few treatments.

Suboccipital Headache (aka Muscle Tension Headache)

This is a headache caused by a specific muscle spasm (tenderness) at the base of your skull, named Suboccipital Muscles. This is the most common type of primary headaches. The signs and symptoms of these types of headaches are outlined below:

• ·         Pain usually on two side of the head

• ·         No nausea and/or vomiting

• ·         Pain starts at the base of the skull, moves to the side of the head and behind the eye

• ·         It can co-exist with neck pain and lack of range of motion in the neck

The primary way of treating this headache is to work with your spine and the muscles surrounding your spine in the neck region by manipulation, stretches and corrective posture.

Keeping in mind the different types of headaches, the purpose of this blog is not to diagnose you over the internet; it is for you to have enough information about the differences between the Migraine and Suboccipital headaches (which are more common!), and a possible alternative treatment to pain medications.

Dr. Ali Masoumi
www.facebook.com/drmasoumi