How are back and neck conditions diagnosed?
The most important part of your evaluation is a physical exam
and medical history performed by your doctor. In addition, various
diagnostic tests may be used to help diagnose back and neck
disorders, including:
- Laboratory tests -- These may include
tests on blood, urine, joint fluid and other body fluids. In many
cases, laboratory tests are used to help rule out other diseases or
injuries as the cause of your symptoms.
- X-rays -- Spine X-rays provide detailed
images of the bones of the spine. Spine X-rays can help detect many
disorders, including fractures (breaks), tumors (abnormal masses of
cells), arthritis, deformities in the curves of the spine (such as
scoliosis), and osteoporosis (thinning of the bones).
- Computed tomography (CT) scan -- A CT
scan uses X-rays and computers to produce cross-sectional images.
The CT scanner is a doughnut-shaped machine that takes multiple
pictures of the body, called slices, which the computer reformats
into cross-sectional images. CT scans provide excellent detail of
the bones of the spine, and are helpful in diagnosing small
fractures and other bone-related spinal disorders that do not show
up on a spine X-ray. Narrowing of the spinal canal can also be
visualized on a CT scan.
- Magnetic resonance imaging (MRI) scan --
MRI uses a large magnet and a computer -- rather than X-rays -- to
produce detailed images of organs and structures inside the body.
MRI produces clear images of soft tissues, and is useful in
diagnosing disorders of the brain, spinal cord and joints.
- Spinal tap -- A spinal tap involves
placing a needle into the spinal canal and withdrawing a sample of
cerebrospinal fluid, the fluid that surrounds and nourishes the
spinal cord. The fluid is examined for evidence of bleeding and/or
infection.
- Myelogram -- This is a special type of
X-ray used to detect problems of the spinal canal, spinal cord,
disks and nerve roots. A dye that helps to outline the spinal cord
and nerve roots is injected into the spinal canal, after which a CT
scan of the spine is taken.
- Discogram -- This test is used to
determine why a spinal intervertebral disc is painful. Contrast dye
is injected into the disk or disks to be studied. Tears or cracks
in the annulus of the disk can be visualized.
- Bone scan -- A bone scan is a test that
looks for areas where there is a higher than normal level of bone
repair activity, also called bone turnover. Bone turnover may be
caused by very small fractures (breaks), infections and cancer.
During a bone scan, the patient is given a small amount of
radioactive material, called a tracer, which concentrates in areas
that are actively involved in bone turnover. After a waiting
period, a scanning camera is moved across the patient's body.
The camera is able to detect the radioactive tracer, which emits
gamma rays. A computer analyzes the gamma rays to form an
image.
- Electromyelogram (EMG) -- An EMG is used
to evaluate the activity of the spinal nerve roots. The test
involves placing small needles into various muscles and measuring
the electrical activity. The muscles' response, which
indicates the degree of nerve activity, is measured. Another test,
called a nerve conduction study, often is done at the same time as
an EMG. Nerve conduction studies measure how fast an impulse is
transmitted from one nerve to another.