Procedures Xrays Radiographs Computerized Tomography CT scan Myelogram

Procedures • • • X-rays (Radiographs) Computerized Tomography (CT scan) Myelogram Magnetic Resonance Imaging (MRI) Bone Density Scan (DXA)

X-rays (Radiographs) • • X-rays are noninvasive and can help physicians detect: aging changes in the spine and the discs spinal alignment and curvature spinal instability congenital (birth) defects of the spinal column fractures caused by trauma osteoporosis infections some tumors

Computerized Tomography (CT scan) They are especially useful in: • visualizing degenerative or aging changes in the spine, • spinal alignment • fractures and fracture patterns • congenital/ childhood anomalies of the spine, • herniated discs, and areas of narrowing in the spinal canal through which the spinal cord and spinal nerve roots pass.

Myelogram • Myelogram is a dye study to better identify areas where the spinal cord and/or spinal nerves may be compressed. Typically, under a local anesthetic, the physician, often a radiologist, places a needle into the spinal canal in the lower back and injects a dye, which mixes with spinal fluid and runs through the spinal canal • X-rays and often a CT scan are done after the dye is injected which may show areas where the dye is blocked. • These images allow physicians to visualize areas of narrowing in the spinal canal. • A myelogram may be ordered when there is a contraindication to obtaining an MRI scan

Myelogram

Magnetic Resonance Imaging (MRI) MRI has become the gold standard in establishing a diagnosis for many patients with spinal disorders. • abnormalities of the bones of the spine • MRI is sensitive for detecting aging changes in the discs, herniated and bulging discs, areas of narrowing and compression of the spinal cord and spinal nerve roots • birth/congenital problems • spinal infections • tumors • Fractures • injuries to the soft tissues/ligaments supporting the spinal column • MRI is excellent for visualizing abnormalities of the spinal cord. • Intravenous contrast is sometimes administered to better visualize certain structures or abnormalities in the spine.

Magnetic Resonance Imaging (MRI)

ﻣﻮﺍﺭﺩ ﻣﻮﺭﺩ ﺑﺤﺚ • • Congenital Deformities Myelopathy Atlanto-axial Subluxation Chronic Neck Pain Thorasic Spine Pain Chronic LBP Acute LBP

Red Flags- Low Back Pain Red Flags – low back pain 1. Indicate possible serious pathology 2. Indicate the need for further investigation and, possibly, specialist referral Possible fracture * Major trauma * Minor trauma in elderly or osteoporotic patient Possible tumor/infection * Age < 20 or > 50 years * History of cancer * Constitutional symptoms (fever, chills, weight loss) * IV drug use * Immunosuppression * Pain worse at night or when supine Possible significant neurological deficit * Severe or progressive sensory alteration or weakness * Bladder or bowel dysfunction * On physical examination: evidence of neurological deficit (in legs or perineum in the case of low back pain)

ﺑیﻤﺎﺭی ﻫﺎی گﺮﺩﻥ • • • Thyroid Parathyroid Salivary glands Neck masses Foreign body TMJ

SALIVARY MASS Superficial Parotid sonography Sublingual , submandibular , accessory MRI, CT