Workers in North Carolina and Virginia who are seriously injured are likely to undergo one or more diagnostic tests. These tests can determine what injuries or illnesses you have. Diagnostic tests can also rule out certain medical conditions. Diagnostic tests are important in workers’ compensation cases because they can be used to explain why you’re not working, what medical care you will need, and why you may not be able to work again for a long time – or may have a permanent disability.
Most injured workers are examined at a local emergency room. These ER doctors will likely order the first round of tests. Your family doctor and medical specialists may order additional tests.
Imaging tests
One common type of diagnostic tests are imaging tests that examine the inner workings of your body. The three common types of radiology tests are X-rays, MRIs, and CT scans.
X-rays
X-rays are used to examine whether you have any fractures, broken bones, or dislocations. They can also be used to find certain types of infections. These tests are generally non-invasive and can performed at the ER facility or the medical office where you are being evaluated. Generally, the danger of radiation exposure is low compared to the benefits of diagnosing your condition. Some exceptions such as diagnosing someone who is pregnant may apply.
According to the Mayo Clinic, X-ray beams pass through your body.
“These beams are absorbed in different amounts depending on the density of the material they pass through. Dense materials, such as bone and metal, show up as white on X-rays. The air in the lungs shows up as black. Fat and muscle appear as shades of gray.”
Some X-ray tests use a contrast medium, such as barium or iodine, to obtain more detail on the images.
X-rays are saved digitally on computers. They can be examined within a few minutes.
MRIs
MRI is short for Magnetic Resonance Imaging. These imaging tests are used to detect muscle damage, torn ligaments, and other soft tissue injuries. They’re most often used to examine spinal cord, spinal disc, and brain damage. MRIs are also used to observe inflammation.
The MRI is an imaging technique that uses “a magnetic field and computer-generated radio waves to create detailed images of the organs and tissues in your body.” Typically, an MRI machine uses large, tube-shaped magnets. As you lie inside the machine, “the magnetic field inside works with radio waves and hydrogen atoms in your body to create cross-sectional images — like slices in a loaf of bread.”
Bone and joint MRIs are used to determine if a worker has:
- Torn cartilage, ligaments, or other repetitive stress injuries
- Spinal disc problems.
- Infections of any bones.
- Bone and tissue tumors
Normally, the MRI test is conducted at a special diagnostic center. Before taking the MRI exam, you’ll be asked if you have any metal or electronic devices in your body. If so, you and the MRI examiner will need to review what items you can safely remove and whether the remaining times are MRI-safe. Many items such as jewelry, eyeglasses, watches, dentures, hearing aids, and underwire bras may affect the ability to take the test.
The MRI machine looks like a narrow long tube which is open on both sides. You’ll be placed on a movable table that slides into the tube’s openings. Most workers don’t have problems, but some may require medication to help the worker be less anxious and not move. You must remain completely immobile for the duration of the imaging. The test is painless. There aren’t any moving parts around you. There will be some noise. This is usually explained by the radiology technician, who can communicate with you via a speaker while you are inside the tube. You are also usually given earplugs to reduce the noise as the machines can be quite noisy during imaging.
“In some cases, a contrast material, typically gadolinium, will be injected through an intravenous (IV) line into a vein in a hand or arm. The contrast material helps make certain details clearer. Gadolinium rarely causes allergic reactions.”
The MRI test lasts between 15 and 60 minutes. During that time, you must be as still as possible. You should be able to conduct your usual activities immediately afterwards – unless you have been sedated.
There are some people who are claustrophobic and unable to complete the test in a normal MRI machine. For those patients, there are some facilities that have Open MRI, which is open on four sides with the magnet above and below the patient, so the patient is not fully enclosed inside a metal tube as with the closed MRI.
In either case, a Radiologist interprets the results and reports the findings to your doctor. Your doctor will then explain the results to you; however, while your doctor will certainly look at the report of the radiologist, most Orthopedic surgeons, neurosurgeons or other specialists who have ordered an MRI will also look at the films themselves and form their own opinions, which may or may not differ from the opinion of the radiologist.
CT scans
CT is short for computerized tomography (CT). A CT scan, according to the Mayo Clinic, “combines a series of X-ray images taken from different angles around your body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels, and soft tissues inside your body.” These images are more detailed than X-rays.
CT scans are often used to examine the body after any type of trauma such as a fall, being struck by an object, or a car accident. They help examine fractures, provide guidance for surgeries, and help monitor different types of diseases. They help plan treatments such as cancer treatments (for workers who suffer a cancer-related occupational diseases) and help detect internal bleeding and internal injuries.
There is some risk of radiation exposure. CT scan radiation is generally more intense than X-ray radiation because CT scans are more detailed. According to the Mayo Clinic, the “low doses of radiation used in CT scans have not been shown to cause long-term harm, although at much higher doses, there may be a small increase in your potential risk of cancer.” Newer and faster techniques are helping to reduce the level of exposure. Some workers may be informed that they need to take special dye – a contrast material – before they take the test.
Before the CT scan, you’ll need to remove some or all of your clothing – and wear a hospital gown. The examiner will review what objects might interfere with the test. You’ll need to stop eating or drinking a few hours before the test.
CT scans and done either in a hospital or at an outpatient facility. They’re painless. The exam takes about 30 minutes.
“CT scanners are shaped like a large doughnut standing on its side. You lie on a narrow, motorized table that slides through the opening into a tunnel. Straps and pillows may be used to help you stay in position. During a head scan, the table may be fitted with a special cradle that holds your head still.”
The technologists may request that you hold your breath during certain parts of the test. You should be able to resume normal activities after the CT scan. You’ll be given special instructions if you are given contrast material.
Like X-rays, the images are stored electronically and viewed on a computer. A radiologist will review the results and inform your doctor of the results and as with MRI’s, your doctor will also be able to view the films and may also form his or her own opinion as to what the films reveal about your condition.
CT Myelogram
A CT myelogram is another type of CT imaging specifically designed to take images of the spine. It uses a contrast material that is injected into the spinal column to highlight problems with spinal cord and the areas that surround it, such as the nerves, discs, and other soft tissues. It will often provide one of the most detailed pictures of any issues with your discs, whether that problem resides in the lumbar spine (low back) or cervical spine (neck).
A myelogram may be ordered after other testing such as MRI or regular CT has failed to satisfy your physician as to what may be causing the problems you are having in your spine. In injury cases, we see these types of tests frequently used to help identify bulging or herniated discs in the spine.
At Joe Miller Law Ltd., our North Carolina and Virginia workers’ compensation lawyer has been fighting for injured workers and workers who develop occupational illnesses for more than 35 years. He’s helped thousands of workers just like you obtain full pay for their medical care – and the temporary and permanent disability benefits they deserve. To discuss all parts of your work injury claim including diagnostic tests, call attorney Joe Miller, Esq. at 888-667-8295 or complete my online contact form to schedule a free consultation.
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