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Chiropractic Clinical Series: 4 Keys to Reading a Spine MRI

Welcome to a new clinical series designed for practicing chiropractors! Today we are talking about the four essential tools that you need to have command knowledge of within your imaging software. We'll go through them one by one.

The four essential tools are- measurement, contrast, magnification, and scout lines. The four tools will get you 98 percent of the information that you need when looking at a spine MRI. I highly encourage working with your radiologist for the complete read. But knowing your way around an MRI will save you from getting super anxious, and you could eliminate a lot of that anxiety by doing a few simple things.

Number one; make sure that you are opening up in your software. Do NOT use "whatever" software comes on the disc. That is a recipe for disaster because all the software is slightly different. Two software packages make viewing images really easy. If you are a PC person, then check out Radiant Viewer. If you are a Mac person than OSIRX is the best tool on the market. They have a free version and a paid version. If you're not a radiologist, then the free version is going to be absolutely perfect for you.

When you open up, you're software you should anticipate seeing, on the left-hand side of the screen, all of the different images that you have lined up in your queue. So whatever's on that disk will show up on the left-hand side.

You should already see the scout lines. Most imaging software including OSIRX WILL allow those scout lens to come up automatically. They just rectify one image or plane against the other. As you scroll the scout lines will then move following where you are. So scout lines are essential only to understanding and rectifying left versus right, up versus down,n and what segment you're at.

The other three measurement contrast in magnification are all located in the same area in almost every software package you open up. All you have to do is go to the middle at the top, and you will see the cluster of tools that you are looking for. And typically, they're pretty obvious. Your magnification is usually the little magnifying glass. Measurement seems like a bit of measuring tape, and then your contrast.

The measurement tool allows you to drag and drop to measure the distance between two items. Very important when you're measuring canal space. You can see how that happens right there.

The magnification tool is the little magnifying glass. This allows you to get in really detailed or pull back out of the picture can be used in conjunction with your measurement tool.

Contrast allows you to brighten or darken the images on the screen. Thankfully we no longer are at the whim of a single "hard" film but can manipulate the contrast from the comfort of our own home.

So, wrapping up. Be sure to download your own software package. OSIRX is a great MRI viewer for Mac and Radiant Viewer for PC. Make sure that you are not at the whim of different software for every disk that you put in or it will be inefficient and confusing.

Don't just rely on the report. I know we can do better. I think we all should be looking at the imaging because we have the luxury of seeing the patient. The radiologist does not typically see the patient. We, as chiropractors, are able to see the functional aspects of what they're going through and correlating that with the images. It's our job to delineate what matters, what doesn't matter and give our patients the best course of action.