X-rays don’t always tell the whole truth

By Dr. Adam Cramer, PT, DPT; MyoFit Clinic

When people have back pain, orthopedic conditions or injuries, the first thing they want to do is get an X-ray or MRI. A picture is worth a thousand words, right?

Well, when it comes to efficiently diagnosing what really ails you, that actually doesn’t hold true.

Oftentimes, there may be abnormalities on an X-ray that are identified, but do not correlate to a person’s symptoms. In fact, a recent study found there were unique abnormalities in 86% of X-rays, ones that could easily trigger false alarms.

In most cases, X-rays and MRIs are unnecessary for an accurate diagnosis. They are also costly and can delay the time until a patient receives treatment. As doctors of physical therapy, a core part of our training is to perform functional examinations to make a diagnosis based on specificity and sensitivity.

The exam begins with observation. We look closely at the patient’s posture and gait. Then we test the muscles, joints and nerves by assessing their range of movement. We pinpoint and compare the affected area with the other non-involved side of the body. Getting to the root cause of what is going wrong is the best course of treatment.

Of course, during our diagnostic due diligence, there are red flags we look for that would require imaging.

For instance, I worked with an 80-year-old woman who was having difficulty walking. There was no pain, but she had balance issues. It came on suddenly, there were no falls or injuries. We did a test to look for neurological deficits. I asked her to touch her nose with her fingers. She did it fine with her eyes open, but when I asked her to do it with her eyes closed, she couldn’t. That was a big red flag. I told her to go to the ER. She did, and they found a brain tumor pushing on her motor cortex that was removed right away.

If you are experiencing pain or have difficulty moving, please see a licensed doctor of physical therapy for an accurate diagnosis, immediate treatment and to avoid surgery.

Founded by Dr. Adam M. Cramer, PT, DPT, MyoFit Clinic is located in Middlefield, 440-632-1007, Chardon, 440-286-1007, and Ashtabula 440-993-1004. Visit MyoFitClinic.com to sign up for telehealth e-visits and find out more.