How to Read MRI Film of Spine, Understand, Pick Relevant Findings, Interpret & Correlate Clinically

Did you know ?
Just reading or doing google search about your MRI report Could be misleading ?
Yes! If you
are only reading the MRI report or Googling it, you are going to the internet, browsing
and checking, what is written there, it could
be misleading.
While reading an MRI report, you read what
is written, not what you need to read. As per systematic review by Brinjikji, et
al, which was published in American Journal of
neuroradiology in Nov. 2014, where they included 33 studies consisting total of 3110 MRI
reportings of asymptomatic participants.
Means neither of these participants were having pain, nor any symptoms.
The systematic review concluded that in MRI reporting, by the age of 40 years, though
asymptomatic, 50% of these participants had disc bulge.
And at the age of 50 years, 60% participants had disc bulge.
Interesting ? Right ?
Now, Lets talk about disc degeneration, at the age of 40 years, 68% participants had
disc degeneration which is the aging process of disc.
So, if you are reading MRI films which report disc degeneration, It is okay to have
disc degeneration. Its natural to have disc degeneration.
Therefore, just reading the MRI report is not good. What is important is that
you correlate it clinically, corelate it with the symptoms of the patient clinically.
Why? Because probably as per this study, 60% people will have disc degeneration at the age of
40 years anyway. At the age of 60 years, 88% (such a high percentage) will have disc degeneration.
And if we talk about disc height loss, at the age of 40 years, 45% people had disc height loss
and, they were all asymptomatic, at the age of 60 years, 67% had disc degeneration.
Remember it is a systematic review, the meta-analysis of 33 studies, including 3110 asymptomatic subjects. Lets talk about facet joint degeneration, it was found that at the age of 20 years, 4% participants had facet joint degeneration; and at the age of 60 years, 50% participants had percent
facet joint degeneration, while at the age of 80 years which is expected also, 83% had facet joint
degeneration.
Now, Let’s talk about spondylolisthesis, the study concluded, that, at the age of 30 years, 5%
participants have spondylolisthesis and at the age of 80 years, 50% participants have
spondylolisthesis, that means if you’re reading all those findings in MRI films, it
might be an incidental finding, and might be already there
since long, so just knowing or just seeing those things are really not good; what is important
here is to correlate clinically.
We have treated more than 100,000 patients in last 28 years.
We have trained more than 12,000 physios in
52 countries. And when we discuss these finding with those
physios, many of them also share almost the similar findings.
I will share an instance with you. A young patient came to our clinic on a stretcher.
Look at the disc bulge here, it’s a huge disc bulge, right. On clinical examination, his SLR was only
10 degrees. You’ll be surprised to know that just after three minutes of manual therapy, his SLR
went up to 70 degrees. Only three minutes from 10 degrees to 70 degrees, that means, the
pain was not coming because of the disc prolapse. So, It is okay to have this disc bulge as
well. this disk is also looking white; this means it’s a healthy disk but look at this disk which is already out, it is black; that means it is dehydrated. I will teach you how to read all those things and
how to correlate clinically, because only reading MRI is not useful, you need to interpret, you need to correlate all those things. So let’s see look at the next slide of the
same patient. this is the axial view, or the transverse section, look at the size of the disk here.
It’s a huge disc bulge, it is the same patient so you should be able to read MRI from the axial
section as well as from sagittal section. I’m going to teach you all of them,
Now, look at that MRI film of another patient, look at the size of the disc, it’s of a big size, this MRI was taken in October 2017 and we taught manual therapy as self-treatment and
then this patient continued self-treatment at home and after one and half year, we got the MRI done again. That means earlier people thought that once the disc is out, it does not go back, actually it does go back, or correctly I shall say it, it gets shrinked over the time. look at the axial view The size of the disc in transverse section before and after one and half year,
look at the disc bulge now, it’s gone, it’s dry, it’s dehydrated, it has shrinked actually.
So please understand that these changes are just a normal part of aging process, so if MRI says something scary don’t be afraid.
Learn how to read and interpret..
In this chapter what I’m going to cover, is the slipped disc, facet joint arthopathy, spinal canal stenosis, spondylolisthesis, multifidus muscle and it’s wasting, mechanical pain and it’s clinical correlation with biomechanics.

Видео How to Read MRI Film of Spine, Understand, Pick Relevant Findings, Interpret & Correlate Clinically канала Prof. Dr. Deepak Kumar Capri