Magnetic Resonance Imaging (MRI) Referral Guidelines
|
|
- Cornelius Montgomery
- 7 years ago
- Views:
Transcription
1 Magnetic Resonance Imaging (MRI) Referral Guidelines Speciality of Radiology March 2011 Version: 1.0 Ratified by (name of Committee): NHS Worcestershire Clinical Senate Date ratified: 8 th March 2011 Date reviewed (WAHT): Expiry date: 19/04/2014 Dr Umesh Udeshi Any revisions to the policy will be based on local and national evidence Review date: WAHT expiry: 19/04/2017 Lead Executive/Director: Simon Hairsnape Name of originator/author: Dr Umesh Udeshi, Worcestershire Acute Hospitals NHS Trust Ms Chris Emerson, Head of Acute Commissioning, NHS Worcester Target audience: NHS Trusts, Independent Providers, GP s, patients Distribution: NHS Trusts, Independent Providers, GP s, patients, Public & Patient Involvement Forum Contribution List Key individuals involved in developing the document Name Dr Umesh Udeshi Dr Richard Davies Designation Consultant Radiologist GP, Redditch & Bromsgrove GPCC WAHT-RAD-011 Page 1 of 6 Version 1.2
2 1. Background MRI scanning is a powerful diagnostic tool and frequently helps to select the most appropriate treatment option and plan management in patients with musculoskeletal disorders. The list below represents abridged guidelines on situations where MRI may or may not be specifically indicated and is based on the Royal College of Radiologists publication Making the Best use of a Department of Clinical Radiology (5 th edition). These Guidelines represent the opinion of experienced specialist radiologists and help to outline a number of clinical presentations and situations where MRI scanning may be of value and others where the investigation may not be indicated. In circumstances where there is clinical doubt or symptoms are severe, unremitting or progressive, urgent assessment by an appropriate specialist clinician should be considered. 2. Referrers Responsibility Referrals for MRI will only be accepted on an appropriate request form. The contraindications section of this form should be filled in; failure to do this will cause a delay or possibly refusal to scan your patient. The referrer must be familiar with the duties and responsibilities of a referrer who must be conversant with the exposure and safety implications that may relate to their patient during the MR examination. Ultimately, the responsibility for the patient s health and well being will rest with them. Referring clinicians must confirm that there are no contraindications to MRI for their patient before referral. Ensure the patient is identifiable from the request form. Name, Date of birth, address, telephone number and NHS number must all be present. An electronic ICE Order Comms request will be expected once rolled out to all practices. Ensure clinical details conform to those in the referral guidelines. If they do not, or there is insufficient information for the practitioner then the examination may not be performed. There must be the referrer s signature and name written legibly in block capitals so that the referrer can be identified. Cases that do not meet the eligibility criteria but are determined to be exceptional should be discussed with the consultant radiologist before referrial for MRI. WAHT-RAD-011 Page 2 of 6 Version 1.2
3 3. Clinical Indicators for MRI Referral: Area and Symptoms Indicated or not Lumbar Spine Sciatica less than 6 weeks with no adverse features (no red flag symptoms or signs) Sciatica failed conservative management Low Back Pain with adverse symptoms or signs Acute Cauda Equina Mid line chronic low back pain without progression Chronic facet joint symptoms and signs but without radiation down leg MRI not usually indicated RCGP guidelines indicate that conservative management is appropriate in sciatica without adverse features, MRI reserved for sciatica which does not resolve within the 6 week period. MRI indicated Clinico-radiological correlation is important, as a significant proportion of disc herniations demonstrated on MRI are asymptomatic MRI spine indicated. Sphincter or gait disturbance Saddle anaesthesia Severe progressive motor loss Widespread neurological deficit Previous carcinoma Systemically unwell weight loss HIV, IV drug abuse Steroids Structural deformity MRI indicated ( Urgent referral via Neurosurgery/specialist orthopaedic route) Sphincter or gait disturbance Saddle anaesthesia Not usually indicated. In the absence of focal or neurological signs, asymptomatic chronic degenerative changes are a common finding. A trial of non interventional treatment ( exercise, physiotherapy, chiropractor treatment may be appropriate) MRI not usually indicated. Non-invasive treatment is often effective. MRI should be reserved for cases with atypical symptoms. WAHT-RAD-011 Page 3 of 6 Version 1.2
4 Thoracic Spine Isolated Chronic Back Pain - Without adverse features or radiation Thoracic pain with radicular radiation - long tract signs or persistent symptoms. Cervical Spine MRI Not Usually Indicated. MRI very rarely identifies treatable lesions in the absence of focal features. Imaging is rarely useful in the absence of neurological signs or pointers of metastases or infection MRI Thoracic Spine Indicated In adults thoracic radicular pain may be an early sign of impending cord compression. Acute thoracic pain in elderly patients may require more urgent referral for imaging to assess for vertebral collapse. Plain radiographs are often adequate with MRI reserved for complex cases. Neck pain with brachalgia and/or neurological signs Acute Neck pain Chronic Neck Pain MRI Cervical spine Indicated In patients where pain affects lifestyle, is unresponsive to conservative treatment or there are adverse features (eg long tract signs). MRI is most useful where there are single root symptoms and signs, and least useful where symptoms and signs referable to multiple dermatomes. MRI not Usually Indicated Severe or adverse features only. Most neck pain resolves on conservative treatment. Degenerative changes are invariably seen on MRI beginning early middle age and are often unrelated to symptoms. MRI Not Usually Indicated Degenerative changes are invariably seen on MRI beginning early middle age and are often unrelated to symptoms. Hip Hip Pain MRI Pelvis Not Usually Indicated (5) X-ray or MRI only if symptoms and signs persist or there is a complex history. X-Ray usually 1 st line investigation. Hip pain with suspected avascular necrosis MRI Hip Indicated X-Ray usually 1 st line investigation. WAHT-RAD-011 Page 4 of 6 Version 1.2
5 Knee Acute Knee Pain Following trauma or accident, in previously non-symptomatic joint. Long-Standing Knee Pain (18-50 Year Old) MRI Knee Indicated Especially under the age of 50 and without signs of osteoarthritis X-Ray usually 1 st line investigation. MRI Knee Indicated Particularly for suspected ligament or meniscal injury. Long-Standing Knee Pain (Over 50 years Old) Ankle and Foot Ankle and foot Symptoms Shoulder Non localised shoulder pain Shoulder impingement syndrome, shoulder instability, rotator cuff tear Elbow Elbow Symptoms MRI Knee Indicated (Following X- Ray) In patients over 50 a plain film should be performed before requesting MRI as this can highlight joint degeneration, when MRI may not be indicated. Specialist Referral MRI should be used selectively and normally only requested by a specialist clinician. MRI not usually indicated Specialist referral. MRI may be useful. This is usually a clinical diagnosis. Imaging only indicated after initial conservative management or if invasive treatment being considered. Specialist Referral Usually reserved for when surgical intervention is being considered. Wrist Wrist Symptoms Specialist Referral Usually reserved for when surgical intervention considered. Brain Headache MRI Brain Indicated - Although MRI should be used selectively and normally only requested by a specialist clinician. Imaging in chronic headache without focal neurology is usually unrewarding. WAHT-RAD-011 Page 5 of 6 Version 1.2
6 4. Exclusions: There are a number of Contraindications to MRI. Pacemakers Implantable cardioverter-defibrillators Cochlear implants Confirmed metallic foreign body in orbit of eye Vagus nerve stimulators Neuro stimulator Cerebral aneurysm clip in the brain Capsules retained from Capsule Endoscopy 5. Cautionary The following are a list of implants that will need to be determined as MRI safe prior to the MRI examination. The provider will obtain and cross check the make and model number against a MRI safety register. Where the implant is determined to be safe the patient episode will continue, however where the implant is determined to be unsafe the request will be rejected on grounds of safety. Also listed are circumstances where extra precautions and patient awareness will be addressed with the patient prior to the examination, and which may lead to deferral of the examination. Heart valve Replacement (Please include details of make, type, details of when and where surgery performed if possible) Intra-vascular stents, filters and coils Ocular implants Shrapnel injuries Penile implants Any other unknown implant until it has been determined as MRI safe 1 st Trimester of pregnancy Recent metallic implants or clips (within 6 weeks) WAHT-RAD-011 Page 6 of 6 Version 1.2
Low Back Pain Protocols
Low Back Pain Protocols Introduction: Diagnostic Triage And 1. Patient Group Adults aged 18 years and over with routine low back problems. Patients who have had recent surgery should be referred directly
More informationClinical guidance for MRI referral
MRI for cervical radiculopathy Referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of spine for a patient 16 years or older for suspected: cervical radiculopathy
More informationMusculoskeletal: Acute Lower Back Pain
Musculoskeletal: Acute Lower Back Pain Acute Lower Back Pain Back Pain only Sciatica / Radiculopathy Possible Cord or Cauda Equina Compression Possible Spinal Canal Stenosis Red Flags Initial conservative
More informationDiagnostic Imaging Exams
Guide for Chiropractors Diagnostic Imaging Exams CREATED FOR OUR CHIROPRACTIC PARTNERS This document has been prepared by the specialized, board-certified radiologists who interpret patient exams for Center
More informationClosed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario
Page 1 Closed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario Injury Descriptions Developed from Newfoundland claim study injury definitions No injury Death Psychological
More informationCLINICAL PRACTICE GUIDELINES FOR MANAGEMENT OF LOW BACK PAIN
CLINICAL PRACTICE GUIDELINES FOR MANAGEMENT OF LOW BACK PAIN Low back pain is very common, up to 90+% of people are affected by back pain at some time in their lives. Most often back pain is benign and
More informationClinical Guideline. Low Back Pain Orthopaedics. Princess Alexandra Hospital Emergency Department. 1 Purpose. 2 Background
Princess Alexandra Hospital Emergency Department Clinical Guideline Orthopaedics Review Officer: Katherine Isoardi Version no: 1 Approval date: 18/03/2015 Review date: 18/03/2017 Approving Officer Dr James
More informationSpinal Surgery 2. Teaching Aims. Common Spinal Pathologies. Disc Degeneration. Disc Degeneration. Causes of LBP 8/2/13. Common Spinal Conditions
Teaching Aims Spinal Surgery 2 Mr Mushtaque A. Ishaque BSc(Hons) BChir(Cantab) DM FRCS FRCS(Ed) FRCS(Orth) Hunterian Professor at The Royal College of Surgeons of England Consultant Orthopaedic Spinal
More informationSpine Trauma: When to Transfer. Alexander Ching, MD Director, Orthopaedic Spine Trauma OHSU
Spine Trauma: When to Transfer Alexander Ching, MD Director, Orthopaedic Spine Trauma OHSU Disclosures Depuy Spine Consultant (teaching and courses) Department education and research funds Atlas Spine
More informationMeasure Title X RAY PRIOR TO MRI OR CAT SCAN IN THE EVAULATION OF LOWER BACK PAIN Disease State Back pain Indicator Classification Utilization
Client HMSA: PQSR 2009 Measure Title X RAY PRIOR TO MRI OR CAT SCAN IN THE EVAULATION OF LOWER BACK PAIN Disease State Back pain Indicator Classification Utilization Strength of Recommendation Organizations
More informationSample Treatment Protocol
Sample Treatment Protocol 1 Adults with acute episode of LBP Definition: Acute episode Back pain lasting
More informationA Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH)
A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH) Introduction Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a phenomenon that more commonly affects older males. It is associated
More informationBACK PAIN PATHWAY DEFINTIONS
BACK PAIN PATHWAY DEFINTIONS Cauda Equina Syndrome (CES) Current or imminent compression of the sacral nerve roots resulting in neurogenic bladder and bowel dysfunction. Symptoms typically include: severe
More informationHow To Get An Mri Of The Lumbar Spine W/O Contrast
Date notice sent to all parties: May 27, 2014 IRO CASE #: ReviewTex, Inc. 1818 Mountjoy Drive San Antonio, TX 78232 (phone) 210-598-9381 (fax) 210-598-9382 reviewtex@hotmail.com Notice of Independent Review
More information6/3/2011. High Prevalence and Incidence. Low back pain is 5 th most common reason for all physician office visits in the U.S.
High Prevalence and Incidence Prevalence 85% of Americans will experience low back pain at some time in their life. Incidence 5% annual Timothy C. Shen, M.D. Physical Medicine and Rehabilitation Sub-specialty
More information.org. Herniated Disk in the Lower Back. Anatomy. Description
Herniated Disk in the Lower Back Page ( 1 ) Sometimes called a slipped or ruptured disk, a herniated disk most often occurs in your lower back. It is one of the most common causes of low back pain, as
More informationIf you or a loved one have suffered because of a negligent error during spinal surgery, you will be going through a difficult time.
If you or a loved one have suffered because of a negligent error during spinal surgery, you will be going through a difficult time. You may be worried about your future, both in respect of finances and
More informationGUIDELINES FOR ASSESSMENT OF SPINAL STABILITY THE CHRISTIE, GREATER MANCHESTER & CHESHIRE. CP57 Version: V3
GUIDELINES FOR ASSESSMENT OF SPINAL STABILITY THE CHRISTIE, GREATER MANCHESTER & CHESHIRE Procedure Reference: Document Owner: CP57 Version: V3 Dr V. Misra Accountable Committee: Acute Oncology Group Network
More informationAdvanced Practice Provider Academy
(+)Dean T. Harrison, MPAS,PA C,DFAAPA Director of Mid Level Practitioners; Assistant Medical Director Clinical Evaluation Unit, Division of Emergency Medicine, Department of Surgery, Duke University Medical
More informationTest Request Tip Sheet
With/Without Contrast CT, MRI Studies should NOT be ordered simultaneously as dual studies (i.e., with and without contrast). Radiation exposure is doubled and both views are rarely necessary. The study
More information.org. Cervical Spondylosis (Arthritis of the Neck) Anatomy. Cause
Cervical Spondylosis (Arthritis of the Neck) Page ( 1 ) Neck pain can be caused by many things but is most often related to getting older. Like the rest of the body, the disks and joints in the neck (cervical
More informationWhiplash injuries can be visible by functional magnetic resonance imaging. Pain Research and Management Autumn 2006; Vol. 11, No. 3, pp.
Whiplash injuries can be visible by functional magnetic resonance imaging 1 Bengt H Johansson, MD FROM ABSTRACT: Pain Research and Management Autumn 2006; Vol. 11, No. 3, pp. 197-199 Whiplash trauma can
More informationLOW BACK PAIN; MECHANICAL
1 ORTHO 16 LOW BACK PAIN; MECHANICAL Background This case definition was developed by the Armed Forces Health Surveillance Center (AFHSC) for the purpose of epidemiological surveillance of a condition
More informationInformation on the Chiropractic Care of Lower Back Pain
Chiropractic Care of Lower Back Pain Lower back pain is probably the most common condition seen the the Chiropractic office. Each month it is estimated that up to one third of persons experience some type
More informationThe Spine Center at Beth Israel Deaconess
Spinal Pain The Spine Center at Beth Israel Deaconess Medical Center developed the following detailed eplanation of our care pathways for primary care providers to help support your interactions with patients
More informationTemple Physical Therapy
Temple Physical Therapy A General Overview of Common Neck Injuries For current information on Temple Physical Therapy related news and for a healthy and safe return to work, sport and recreation Like Us
More informationPain Management Top Diagnosis Codes (Crosswalk)
Pain Management Top s (Crosswalk) 274.00 Gout arthropathy, M1000 Idiopathic gout, unspecified site unspecified M10011 Idiopathic gout, right shoulder M10012 Idiopathic gout, left shoulder M10019 Idiopathic
More informationDoctor of Science in Physical Therapy
Doctor of Science in Physical Therapy The mission for the Doctor of Science (Sc.D.) Program in Physical Therapy is to provide advanced post-professional education to practicing physical therapists in Texas
More information1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or
1 REVISOR 5223.0070 5223.0070 MUSCULOSKELETAL SCHEDULE; BACK. Subpart 1. Lumbar spine. The spine rating is inclusive of leg symptoms except for gross motor weakness, bladder or bowel dysfunction, or sexual
More informationICD-10 Cheat Sheet Frequently Used ICD-10 Codes for Musculoskeletal Conditions *
ICD-10 Cheat Sheet Frequently Used ICD-10 Codes for Musculoskeletal Conditions * Finding the ICD-10 equivalent for an ICD-9 code can be a challenge. This resource of frequently used codes can help when
More informationPathoanatomical Changes of the Brachial Plexus and of C5-C6 Following Whiplash-Type Injury: A Case Report
Pathoanatomical Changes of the Brachial Plexus and of C5-C6 Following Whiplash-Type Injury: A Case Report 1 Journal Of Whiplash & Related Disorders Vol. 1, No, 1, 2002 Gunilla Bring, Halldor Jonsson Jr.,
More informationSPINAL STENOSIS Information for Patients WHAT IS SPINAL STENOSIS?
SPINAL STENOSIS Information for Patients WHAT IS SPINAL STENOSIS? The spinal canal is best imagined as a bony tube through which nerve fibres pass. The tube is interrupted between each pair of adjacent
More informationKhaled s Radiology report
Khaled s Radiology report Patient Name: Khaled Adli Moustafa Date 06/15/2014 The patient is not present. And the following report is based upon what was in the MRI of the cervical and lumbar spine report
More informationTHE LUMBAR SPINE (BACK)
THE LUMBAR SPINE (BACK) At a glance Chronic back pain, especially in the area of the lumbar spine (lower back), is a widespread condition. It can be assumed that 75 % of all people have it sometimes or
More informationTreating Bulging Discs & Sciatica. Alexander Ching, MD
Treating Bulging Discs & Sciatica Alexander Ching, MD Disclosures Depuy Spine Teaching and courses K2 Spine Complex Spine Study Group Disclosures Take 2 I am a spine surgeon I like spine surgery I believe
More informationNonoperative Management of Herniated Cervical Intervertebral Disc With Radiculopathy. Spine Volume 21(16) August 15, 1996, pp 1877-1883
Nonoperative Management of Herniated Cervical Intervertebral Disc With Radiculopathy 1 Spine Volume 21(16) August 15, 1996, pp 1877-1883 Saal, Joel S. MD; Saal, Jeffrey A. MD; Yurth, Elizabeth F. MD FROM
More informationSPINE ANATOMY AND PROCEDURES. Tulsa Spine & Specialty Hospital 6901 S. Olympia Avenue Tulsa, Oklahoma 74132
SPINE ANATOMY AND PROCEDURES Tulsa Spine & Specialty Hospital 6901 S. Olympia Avenue Tulsa, Oklahoma 74132 SPINE ANATOMY The spine consists of 33 bones called vertebrae. The top 7 are cervical, or neck
More informationCONSENT FOR MRI SCAN WITH INTRAVENOUS CONTRAST
CONSENT FOR MRI SCAN WITH INTRAVENOUS CONTRAST Your Doctor has asked that an MRI scan be performed using intravenous contrast. This contrast may give the radiologist additional information that may not
More informationManagement of spinal cord compression
Management of spinal cord compression (SUMMARY) Main points a) On diagnosis, all patients should receive dexamethasone 10mg IV one dose, then 4mg every 6h. then switched to oral dose and tapered as tolerated
More informationReturn to same game if sx s resolve within 15 minutes. Return to next game if sx s resolve within one week Return to Competition
Assessment Skills of the Spine on the Field and in the Clinic Ron Burke, MD Cervical Spine Injuries Sprains and strains Stingers Transient quadriparesis Cervical Spine Injuries Result in critical loss
More informationBack & Neck Pain Survival Guide
Back & Neck Pain Survival Guide www.kleinpeterpt.com Zachary - 225-658-7751 Baton Rouge - 225-768-7676 Kleinpeter Physical Therapy - Spine Care Program Finally! A Proven Assessment & Treatment Program
More informationREFERRAL GUIDELINES: NEUROSURGERY
Outpatient Referral Guidelines Page 1 1 REFERRAL GUIDELINES: NEUROSURGERY Essential Referral Content Date of birth Demographic Contact details (including mobile phone) Referring GP details Interpreter
More informationCervical Spine Surgery. Orthopaedic Nursing Seminar. Dr Michelle Atkinson. Friday October 21 st 2011. Cervical Disc Herniation
Cervical Spine Surgery Dr Michelle Atkinson The Sydney and Dalcross Adventist Hospitals Orthopaedic Nursing Seminar Friday October 21 st 2011 Cervical disc herniation The most frequently treated surgical
More informationMagnetic Resonance Imaging
Magnetic Resonance Imaging North American Spine Society Public Education Series What Is Magnetic Resonance Imaging (MRI)? Magnetic resonance imaging (MRI) is a valuable diagnostic study that has been used
More informationX Stop Spinal Stenosis Decompression
X Stop Spinal Stenosis Decompression Am I a candidate for X Stop spinal surgery? You may be a candidate for the X Stop spinal surgery if you have primarily leg pain rather than mostly back pain and your
More informationPhysiotherapy fees and utilization guidelines for auto insurance accident claimants
No. A-12/97 Property & Casualty ) Auto Physiotherapy fees and utilization guidelines for auto insurance accident claimants To the attention of all insurance companies licensed to transact automobile insurance
More informationElectrodiagnostic Testing
Electrodiagnostic Testing Electromyogram and Nerve Conduction Study North American Spine Society Public Education Series What Is Electrodiagnostic Testing? The term electrodiagnostic testing covers a
More informationExtended Disability Income. Fixed cease age. Extended Disability Income. Whole Life UP TO 24 MONTHS. Pre-retirement.
For intermediaries Sanlam Risk Cover January 2015 Temporary Disability Income benefit (OIT3) Primary Income Protector benefits Waiting period Sickness Temporary Disability Income Including fixed payment
More informationDiscogenic Low Backache A clinical and MRI correlative study A DISSERTATION SUBMITTED TO UNIVERSITY OF SEYCHELLES AMERICAN INSTITUTE OF MEDICINE
Discogenic Low Backache A clinical and MRI correlative study A DISSERTATION SUBMITTED TO UNIVERSITY OF SEYCHELLES AMERICAN INSTITUTE OF MEDICINE IN PARTIAL FULFILLMENT OF THE REGULATIONS FOR THE AWARD
More informationColossus Important Diagnoses. Instructions for How to List Diagnoses
1 Colossus Important Diagnoses Instructions for How to List Diagnoses 1. Only list diagnoses on HCFA-1500 or CMS-1500 billing forms 2. Use as many billing forms/pages as necessary (4 diagnoses per billing
More informationBACK PAIN MEASURES GROUP OVERVIEW
2014 PQRS OPTIONS F MEASURES GROUPS: BACK PAIN MEASURES GROUP OVERVIEW 2014 PQRS MEASURES IN BACK PAIN MEASURES GROUP: #148. Back Pain: Initial Visit #149. Back Pain: Physical Exam #150. Back Pain: Advice
More informationHitting a Nerve: The Triggers of Sciatica. Bruce Tranmer MD FRCS FACS
Hitting a Nerve: The Triggers of Sciatica Bruce Tranmer MD FRCS FACS Disclosures I have no financial disclosures Objectives - Sciatica Historical Perspective What is Sciatica What can cause Sciatica Clinical
More informationCervical Spondylosis (Arthritis of the Neck)
Copyright 2009 American Academy of Orthopaedic Surgeons Cervical Spondylosis (Arthritis of the Neck) Neck pain is extremely common. It can be caused by many things, and is most often related to getting
More informationHerniated Disk in the Lower Back
Nader M. Hebela, MD Fellow of the American Academy of Orthopaedic Surgeons http://orthodoc.aaos.org/hebela Cleveland Clinic Abu Dhabi Cleveland Clinic Abu Dhabi Neurological Institute Al Maryah Island
More informationNeck Pain Overview Causes, Diagnosis and Treatment Options
Neck Pain Overview Causes, Diagnosis and Treatment Options Neck pain is one of the most common forms of pain for which people seek treatment. Most individuals experience neck pain at some point during
More informationAdult Spine Rotation Specific Evaluation Orthopaedic Surgery Training Program School of Medicine, Queen s University
Adult Spine Rotation Specific Evaluation Orthopaedic Surgery Training Program School of Medicine, Queen s University CanMEDS Roles / Competencies Name: PGY Rotation Dates: s s Exceeds N/A Attending Staff:
More informationDiagnosis and Management for Chronic Back Pain: Critical for your Recovery
Diagnosis and Management for Chronic Back Pain: Critical for your Recovery Dr. Connie D Astolfo, DC, PhD (candidate) In past articles I have stressed that the causes of back pain can be very complex. This
More informationSpinal Cord Diseases in Bernese Mountain Dogs
Spinal Cord Diseases in Bernese Mountain Dogs 0 A N O V E R V I E W F O R BERNER O W N E R S O R G A N I Z E D B Y N A N C Y M E L O N E, P H. D. Based on materials obtained from the Berner Garde Foundation
More informationCare and Prevention of Sedentary Workplace Injuries. By: Colin Beattie, BKIN, mpt, cafci Registered physical therapist & medical acupuncturist
Care and Prevention of Sedentary Workplace Injuries By: Colin Beattie, BKIN, mpt, cafci Registered physical therapist & medical acupuncturist Learning Objectives By the end of this presentation you should
More informationHerniated Disk. This reference summary explains herniated disks. It discusses symptoms and causes of the condition, as well as treatment options.
Herniated Disk Introduction Your backbone, or spine, has 24 moveable vertebrae made of bone. Between the bones are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep
More informationWhat is a Sports Physician?
What is a Sports Physician? Dr Mike Bundy MBBS MRCGP Dip Sports Med FFSEM Consultant in Sport and Exercise Medicine Medical Director at Pure Sports Medicine Ex-England Rugby senior team Doctor www.puresportsmed.com
More informationDIVISION OF RHEUMATOLOGY DEPARTMENT OF MEDICINE UNIVERSITY OF WESTERN ONTARIO POSTGRADUATE EDUCTION ORTHOPAEDIC OFF-SERVICE GOALS & OBJECTIVES
DIVISION OF RHEUMATOLOGY DEPARTMENT OF MEDICINE UNIVERSITY OF WESTERN ONTARIO POSTGRADUATE EDUCTION ORTHOPAEDIC OFF-SERVICE GOALS & OBJECTIVES GOAL #1 develop the ability to order and understand interpretation
More informationContents. Introduction 1. Anatomy of the Spine 1. 2. Spinal Imaging 7. 3. Spinal Biomechanics 23. 4. History and Physical Examination of the Spine 33
Contents Introduction 1. Anatomy of the Spine 1 Vertebrae 1 Ligaments 3 Intervertebral Disk 4 Intervertebral Foramen 5 2. Spinal Imaging 7 Imaging Modalities 7 Conventional Radiographs 7 Myelography 9
More informationMRI Ordering Guide: MRA/MRV TO SCHEDULE AN APPOINTMENT: CALL (860) 714-XRAY (714-9729) or FAX REQUISITION TO (860) 714-8002
SAINT SAINT FRANCIS Hospital and Hospital Medical and Medical Center Center MRI Ordering Guide: MRA/MRV MRA Abdomen AAA (abdominal aortic aneurysm Dissection Mesenteric Ischemia MRA Abdomen With & Without
More informationBRIEFING PAPER THE USE OF RED FLAGS TO IDENTIFY SERIOUS SPINAL PATHOLOGY THE CHRISTIE, GREATER MANCHESTER & CHESHIRE. Version:
BRIEFING PAPER THE USE OF RED FLAGS TO IDENTIFY SERIOUS SPINAL PATHOLOGY THE CHRISTIE, GREATER MANCHESTER & CHESHIRE Procedure Reference: Document Owner: Jackie Turnpenney Lena Richards Version: Accountable
More informationCERVICAL SPONDYLOSIS
CERVICAL SPONDYLOSIS Dr. Sahni B.S Dy. Chief Medical Officer, ONGC Hospital Panvel-410221,Navi Mumbai,India Introduction The cervical spine consists of the top 7 vertebrae of the spine. These are referred
More informationX-ray (Radiography) - Bone
Scan for mobile link. X-ray (Radiography) - Bone Bone x-ray uses a very small dose of ionizing radiation to produce pictures of any bone in the body. It is commonly used to diagnose fractured bones or
More informationObjectives. Spinal Fractures: Classification Diagnosis and Treatment. Level of Fracture. Neuro exam Muscle Grading
Objectives Spinal Fractures: Classification Diagnosis and Treatment Johannes Bernbeck,, MD Review and apply the understanding of incidence and etiology of VCF. Examine conservative and operative management
More informationPathophysiology of Acute and Chronic Low Back Pain
Pathophysiology of Acute and Chronic Low Back Pain Mary Beth Partyka MSN APN Adult Nurse Practitioner Adult Pain Service Advocate Christ Medical Center Presentation Objectives Review the incidence of acute
More informationMedical report form. Section A - Claimant's details. Dr Alec Manchester MBBS, MRCP, MPH MBBS, MRCP, MPH. Occupation. Address.
Medical report form Dr Alec Manchester MBBS, MRCP, MPH MBBS, MRCP, MPH Section A - Claimant's details Claimants full name Date of Birth Mr Joe Blogg 01/01/1976 Occupation Address Sales Assistant 108 Ellesmere
More information.org. Fractures of the Thoracic and Lumbar Spine. Cause. Description
Fractures of the Thoracic and Lumbar Spine Page ( 1 ) Spinal fractures can vary widely in severity. While some fractures are very serious injuries that require emergency treatment, other fractures can
More informationLow Back Pain ( LBP )
LOWER BACK PAIN Low Back Pain ( LBP ) Most common musculoskeletal problem world wide 85% of all people exp. LBP in lifetime Impacts Life style Quality of life Work UNITED STATES $$$$ 100 BILLION PER YEAR
More information.org. Shoulder Pain and Common Shoulder Problems. Anatomy. Cause
Shoulder Pain and Common Shoulder Problems Page ( 1 ) What most people call the shoulder is really several joints that combine with tendons and muscles to allow a wide range of motion in the arm from scratching
More informationAppointment Types First outpatient. Clinic Types CATS Spine CATS Hip and Knee CATS General Orthopaedic Injection Clinic Podiatry/Foot and Ankle
Clinic Types CATS Spine CATS Hip and Knee CATS General Orthopaedic Injection Clinic Podiatry/Foot and Ankle Conditions Treated Ankle & foot pain & stiffness Back pain & stiffness Carpal Tunnel/ Nerve impingement/entrapment
More informationSurgery for cervical disc prolapse or cervical osteophyte
Mr Paul S. D Urso MBBS(Hons), PhD, FRACS Neurosurgeon Provider Nº: 081161DY Epworth Centre Suite 6.1 32 Erin Street Richmond 3121 Tel: 03 9421 5844 Fax: 03 9421 4186 AH: 03 9483 4040 email: paul@pauldurso.com
More informationAn Easy Guide to TENS Pain Relief. Distibuted By: LgMedSupply.com PO Box 913 Cherry Hill, NJ 08003 www.lgmedsupply.com
An Easy Guide to TENS Pain Relief Distibuted By: LgMedSupply.com PO Box 913 Cherry Hill, NJ 08003 www.lgmedsupply.com 1 LOW BACK PAIN MODE: C Mode PULSE WIDTH: 260 PULSE RATE: 50-80Hz comfortable intensity
More informationPOST SURGICAL RETURN OF RIGHT LEG PAIN. TREATED SUCCESSFULLY WITH COX FLEXION DISTRACTION DECOMPRESSION ADJUSTING
POST SURGICAL RETURN OF RIGHT LEG PAIN. TREATED SUCCESSFULLY WITH COX FLEXION DISTRACTION DECOMPRESSION ADJUSTING A 47 year old white married female was seen for the chief complaint of low back and right
More informationAcute low back pain. Key reviewers: Mr Chris Hoffman, Orthopaedic Surgeon, Mana Orthopaedics, Wellington
Acute low back pain Key reviewers: Mr Chris Hoffman, Orthopaedic Surgeon, Mana Orthopaedics, Wellington Dr John MacVicar, Medical Director, Southern Rehab, Christchurch Key concepts: Acute low back pain
More informationDIFFERENTIAL DIAGNOSIS OF LOW BACK PAIN. Arnold J. Weil, M.D., M.B.A. Non-Surgical Orthopaedics, P.C. Atlanta, GA
DIFFERENTIAL DIAGNOSIS OF LOW BACK PAIN Arnold J. Weil, M.D., M.B.A. Non-Surgical Orthopaedics, P.C. Atlanta, GA MEDICAL ALGORITHM OF REALITY LOWER BACK PAIN Yes Patient will never get better until case
More informationWhite Paper: Reducing Utilization Concerns Regarding Spinal Fusion and Artificial Disc Implants
White Paper: Reducing Utilization Concerns Regarding Spinal Fusion and Artificial Disc Implants For Health Plans, Medical Management Organizations and TPAs Executive Summary Back pain is one of the most
More informationExecutive Summary. SECTION 1: MUA Overview. Procedure
Date: January 10, 2011 Regarding: Manipulation under Anesthesia Prepared By: Joshua Stanfill- Senior Strategic Analyst Executive Summary In a proactive effort to combat medical fraud, the National Insurance
More informationSTATE OF MICHIGAN DEPARTMENT OF ENERGY, LABOR & ECONOMIC GROWTH OFFICE OF FINANCIAL AND INSURANCE REGULATION
In the matter of STATE OF MICHIGAN DEPARTMENT OF ENERGY, LABOR & ECONOMIC GROWTH OFFICE OF FINANCIAL AND INSURANCE REGULATION Before the Commissioner of Financial and Insurance Regulation XXXXX Petitioner
More informationMRI EXAM CPT CODE REFERENCE
I EXAM REFERENCE Use this reference to quickly determine the correct exam for your patients based on the indications described herein and the for the order. Creatine levels should be obtained prior to
More informationA Patient s Guide to Artificial Cervical Disc Replacement
A Patient s Guide to Artificial Cervical Disc Replacement Each year, hundreds of thousands of adults are diagnosed with Cervical Disc Degeneration, an upper spine condition that can cause pain and numbness
More informationInternational Postprofessional Doctoral of Physical Therapy (DPT) in Musculoskeletal Management Program (non US/Canada) Curriculum
International Postprofessional Doctoral of Physical Therapy (DPT) in Musculoskeletal Management Program (non US/Canada) Curriculum Effective: July 2015 INTERNATIONAL POSTPROFESSIONAL DOCTORAL OF PHYSICAL
More informationYOUR MRI EXAM: QUESTIONS AND ANSWERS
YOUR MRI EXAM: QUESTIONS AND ANSWERS What is MRI? MRI is short for Magnetic Resonance Imaging. MRI is an advanced technology that lets your doctor see internal organs, blood vessels, muscles, joints, tumors,
More informationCervical-Spine Injuries: Catastrophic Injury to Neck Sprain. Seth Cheatham, MD
Cervical-Spine Injuries: Catastrophic Injury to Neck Sprain Seth Cheatham, MD 236 Seth A. Cheatham, MD VCU Sports Medicine I have no financial disclosures Contact sports, specifically football, places
More informationIII./8.4.2: Spinal trauma. III./8.4.2.1 Injury of the spinal cord
III./8.4.2: Spinal trauma Introduction Causes: motor vehicle accidents, falls, sport injuries, industrial accidents The prevalence of spinal column trauma is 64/100,000, associated with neurological dysfunction
More informationMN Community Measurement Low Back Pain Measure Impact and Recommendation Document June 2010
MN Community Measurement Low Back Pain Measure Impact and Recommendation Document June 2010 Impact Relevance to Consumers, Employers and Payers Improvability Inclusiveness Mechanical low back pain (LBP)
More informationWhiplash and Whiplash- Associated Disorders
Whiplash and Whiplash- Associated Disorders North American Spine Society Public Education Series What Is Whiplash? The term whiplash might be confusing because it describes both a mechanism of injury and
More informationLow Back Injury in the Industrial Athlete: An Anatomic Approach
Low Back Injury in the Industrial Athlete: An Anatomic Approach Earl J. Craig, M.D. Assistant Professor Indiana University School of Medicine Department of Physical Medicine and Rehabilitation Epidemiology
More informationOn Cervical Zygapophysial Joint Pain After Whiplash. Spine December 1, 2011; Volume 36, Number 25S, pp S194 S199
On Cervical Zygapophysial Joint Pain After Whiplash 1 Spine December 1, 2011; Volume 36, Number 25S, pp S194 S199 Nikolai Bogduk, MD, PhD FROM ABSTRACT Objective To summarize the evidence that implicates
More informationOVERVIEW. NEUROSURGICAL ASSESSMENT CERVICAL PROBLEMS Dirk G. Franzen, M.D. WHAT IS THE MOST IMPORTANT PART OF THE PHYSICAL EXAM?
NEUROSURGICAL ASSESSMENT CERVICAL PROBLEMS Dirk G. Franzen, M.D. Neurological Surgery Bluegrass Orthopaedics and Hand Care OVERVIEW SCOPE OF THE PROBLEM PREVALENCE PATHOLOGY ANATOMIC CONSIDERATIONS ASSESSMENT
More informationOrthopaedic Approach to Back Pain. Seth Cheatham, MD
Orthopaedic Approach to Back Pain Seth Cheatham, MD 262 Seth A. Cheatham, MD VCU Sports Medicine I have no financial disclosures. Focus on clinical situations where a referral to an orthopaedic surgeon
More informationLaser Treatment Policy
Laser Treatment Policy Pursuant to federal law 21 CFR 812.2(c)7 and 812.3(b), physician(s) at this pain center may advise and use unapproved laser s on patients under one or more of the following conditions:
More informationNon-Surgical Spinal Decompression with Computerized Spinal Table (Traction, Deep heat and Massage)
Non-Surgical Spinal Decompression with Computerized Spinal Table (Traction, Deep heat and Massage) for Treating and Rehabilitating Spinal patients New treatment for back problems not just medicines and
More informationDocument Author: Frances Hunt Date 03/03/2008. 1. Purpose of this document To standardise the treatment of whiplash associated disorder.
Guideline Title: WHIPLASH ASSOCIATED DISORDER Document Author: Frances Hunt Date 03/03/2008 Ratified by: Frances Hunt, Head of Physiotherapy Date: 16.09.15 Review date: 16.09.17 Links to policies: All
More informationIMPAIRMENT RATING 5 TH EDITION MODULE II
IMPAIRMENT RATING 5 TH EDITION MODULE II THE SPINE AND ALTERATION OF MOTION SEGMENT INTEGRITY (AOMSI) PRESENTED BY: RONALD J. WELLIKOFF, D.C., FACC, FICC In conjuction with: The chapter on the spine includes
More informationLower-Back Pain. Case One: Management of Back Pain. By Brendan D. Lewis, MD, FRCSC, B.Sc., B. Med. Sc., Dip. Sport. Med.
Focus on CME at Memorial University of Newfoundland Lower-Back Pain By Brendan D. Lewis, MD, FRCSC, B.Sc., B. Med. Sc., Dip. Sport. Med., ABOS, FAAOS Case One: Management of Back Pain A 35-year-old janitor
More information