By Thomas R. Huberty, MD
A generation ago there were two resources people turned to when seeking medical care -- the hospital or their individual doctor’s office. Today, among others, there are additionally medical clinics, convenient care centers and a variety of freestanding diagnostic facilities that include medical laboratories and imaging centers (X-ray, MRI, ultrasound, etc.). There’s even a nurse practitioner ready to see you at your local Walgreen’s. But while the quantity of health care provider options has multiplied greatly, how can you be assured that the quality of care that you receive has been maintained or improved? Specifically, with regard to MRI facilities, can you be sure that what you see is what you get?
Magnetic resonance imaging (MRI) scans are among the most sophisticated diagnostic medical tests available. But not all MRI’s are created equal. There are a number of variables involved in producing MRI’s. Among them are the skill and experience of the individual performing the scan, the quality of the technical components (the MRI machine, the surface coils and the related computer software) and the quality and experience of the individual radiologist reading the scan. All are critically important to produce a scan of the highest quality and we’d like you to know that at Castle Orthopaedics and Sports Medicine, S.C., we’ve paid close attention to each of those variables.
Our two MRI technologists are truly specialists. While they bring a combined 33 years of medical imaging experience to their work including MRI, they have exclusively performed orthopaedic MRI’s of the spine and musculoskeletal system for 8 years. When they perform a scan, they know what to look for and they won’t consider a scan complete until they are certain that a scan of the highest quality has been produced for review by our radiologists and physician specialists. Building on a foundation of experience, they also regularly attend continuing education programs that ensure that their skills are up to date. But beyond their technical skills, they possess precious people skills. They understand that many patients have anxiety about having an MRI and being “in the tunnel”. While they cannot literally hold your hand during the scanning process, they do everything in their power to make patients comfortable and allay their anxieties so that a scan can be completed quickly and efficiently.
When it comes to the technical components of our facility, our Toshiba Opart unit is state of the art for orthopaedic MRI’s. It is an open MRI machine which helps to reduce claustrophobic anxieties that concern many, and the music and reassuring voices of our technologists ease you through the process. Surface coils are devices placed over the body area that is being scanned to improve the quality of the images. Computer software programs is at the heart of creating the MRI pictures and our radiologists (more on them later), have chosen programs that optimize images that show us precisely what we must see to diagnose a wide variety of orthopaedic problems. We don’t perform MRI’s of the abdomen, lung, liver or other parts of the body so that the surface coils and the computer programs work in concert to provide images of the musculoskeletal system that are of the highest quality. But don’t just take our word for it. Though we are a practice that specializes in orthopaedics and sports medicine, we subject our MRI facility to the rigorous review and certification process of the premier radiology accreditation organization in North America, the American College of Radiology (ACR). ACR accreditation is designed to ensure that an imaging facility (in our case our MRI facility) adheres to the highest standards for radiologic quality. Not all imaging facilities can boast accreditation by the ACR, but our facility has earned, and continues to maintain, that accreditation. Feel free to check us out on their website at www.acr.org. You will find that ours is the only MRI facility in Aurora accredited by the American College of Radiology.
Once an MRI scan is complete, the images (pictures) must be reviewed (interpreted) and that is done by radiologists. Radiologists are physicians who, after medical school, complete a residency where they learn to perform and to interpret various imaging studies including X-rays, nuclear medicine scans, CT scans and MRI scans. After residency, some radiologists take an additional period of study (a fellowship) to acquire expertise in a subspecialty of radiology, such as MRI. But a radiologist need not be subspecialty trained to be allowed to read MRI’s. Some radiologists who read MRI’s one day may read mammograms the next, nuclear medicine scans after that and so on and most fellowship trained MRI radiologists will read MRI’s of various body parts each day, spending just a portion of their time focused on orthopaedic studies. It goes without saying that the more time an individual in any field spends doing a single thing, the greater their expertise in that single area. So we have our patient’s MRI’s read by a group of radiologists who specialize in interpreting orthopaedic imaging studies.
National Orthopedic Imaging Associates (NOIA) is a group of radiologists that specialize in advanced diagnostic imaging of the musculoskeletal system and spine. Since 1989 they’ve pioneered the use of teleradiology to create a national orthopaedic imaging network. Their radiologists do NOTHING but read CT scans and MRI’s of the musculoskeletal system. Members of NOIA are actively involved as clinical faculty at two major teaching institutions. They serve as medical advisors to major manufacturers of imaging and teleradiology systems. They are radiologic consultants to a number of high-profile sports organizations, including the San Francisco 49ers, the San Francisco Giants, the US Ski Team, the Cleveland Indians, the Denver Broncos and the Colorado Rockies. NOIA radiologists lecture at national orthopaedic and radiology conferences and they have published many papers in radiology and orthopaedic journals. NOIA annually hosts a national multi-disciplinary educational course entitled “Current Issues in Magnetic Resonance Imaging in Orthopedics and Sports Medicine: A National Symposium”. Their members have authored two books and various chapters on MRI’s of the musculoskeletal system. They are national experts in their field and we are proudly one of just 3 Illinois facilities affiliated with NOIA. You can learn more about them at www.orthoimaging.com.
Once an MRI is completed at our facility, the data is digitally transmitted, in full format, over a dedicated line to an NOIA radiologist. If an abnormality is identified that requires immediate attention, the treating physician is immediately notified by phone or fax and a final report is dictated, signed and transmitted to us within 24 hours. The scans themselves remain part of the patient’s medical record at our office, immediately accessible at any of our offices by our computerized medical record system. The radiologists at NOIA are also continuously available to us for consultation via a direct “Hot Line”.
So what does that mean for you? We hope this illustrates our commitment to provide you with an MRI facility that provides the highest quality advanced orthopaedic imaging for our patients. We also hope that you recognize that an MRI, or any imaging study, is just one tool in our arsenal that assists us in diagnosing your condition so that we may best assist you in regaining your health. The accumulation and integration of your history and symptoms, our physical findings and the results of appropriate tests, ultimately enables us to reach the correct diagnosis. This may even reveal at times that advanced imaging is unnecessary and that a detailed history and careful clinical examination is sufficient to disclose what’s wrong. Frequently the treatment, especially initially, will be the same whether an MRI is done or not.
In closing, there’s been a recent trend in medicine to rely more on advanced imaging and other tests and less on a thorough history and examination. Sometimes patients may think that unless they’ve had an MRI, they haven’t been fully evaluated. It’s important to remember that an MRI isn’t always the appropriate test -- it can’t measure your temperature, pulse, blood pressure or IQ, for example. Therefore, we won’t waste your money (or that of your insurance company!) to do an MRI just so that we can say one was done.
But, if an orthopaedic MRI is called for and is performed at our facility, you can trust that it will be the best quality illustrating once again that at Castle Orthopaedics and Sports Medicine,S.C., “Our Standards Are Simply Higher”.
top of page