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Incorporating Weight-Bearing MRI Into Spine Practices: Q&A With Dr. Douglas Smith of Musculoskeletal Imaging Consultants Featured

Written by  Laura Dyrda | Tuesday, 02 April 2013 18:35
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spine imageDouglas Smith, MD, founder of Musculoskeletal Imaging Consultants, discusses what it takes to incorporate weight-bearing MRI into spine practices.

Q: How can weight-bearing MRI be incorporated into the surgeon's practice?


Dr. Douglas Smith:
Weight-bearing MRI such as the Esaote G-scan Brio provides a cost effective MRI solution for orthopedic and spine practices that desire an in-office MRI unit that excels in the spine but can also examine the hip, shoulder and remainder of the joints with high quality. The price and operating costs are less that 1/3 of other comparable technology on the market.

Q: What are the advantages of using weight-bearing technology over other types of MRI?


DS:
Patients more frequently experience pain from nerve root compression or instability, spinal stenosis, or instability when the patient is standing or weight-bearing than when recumbent and research and European experience have shown 20 to 30 percent larger or more frequent findings with weight-bearing than non-weight-bearing position. Fast cine flexion-extension views can also be performed of the cervical spine. The newer technology includes high efficiency surface coils that produce images of similar quality to high field strength magnets at a much more favorable price point.

shoulder imageQ: How does this new technology impact patient care?


DS:
New weight-bearing MRI is an ideal choice for patients whose symptoms only occur or are worse when standing or weight-bearing. Recumbent MRI scanning of many of these patients would fail to explain their symptoms and they would not receive the proper treatment and suffer needlessly. The Brio has a unique open design and the patients head remains clear outside the scan area.

Q: Where is the trend of weight-bearing MRI headed in the future?


DS:
In the past, upright MRI was not a cost effective solution and produced low resolution images. At last, there is cost-effective method of obtaining high quality weight-bearing imaging of the spine in addition to high quality imaging of all extremities in an open MRI design. I think this will revolutionize orthopedic and spine imaging. Remote operation and online consultation with the radiologist is made possible by the use of a Windows operating system.

Q: How do you anticipate that weight-bearing MRI will impact orthopedic and sports medicine practices?


DS:
MRI during weight-bearing examines the lower extremities in the position where they experience pain. Weight-bearing stresses the labrum of the hip, the menisci of the knee and osteochondral lesions of the knee and talar dome. There are some lesions that can only be evaluated fully during weight-bearing, like sports hernias, high ankle sprains and patellofemoral instability and midfoot or subtalar instability. I believe that functional MRI during weight-bearing will revolutionize orthopedic imaging and now feasible for many orthopedic and spine practices.

Q: How can surgeons acquire weight-bearing MRI systems? Is it profitable? How can they make it that way?


DS:
Companies such as Esaoate have a national sales and service team available online. For interested parties, there is a turn-key management solution can provide installation and operational consultation, technologists, IT services, RIS/PACS, medical directorship, certification/accreditation, data archive and investment protection if in-office exemption repealed. Literally all a practice would need to provide is a site. A typical spine or orthopedic practice would only need to perform three to four  MRI examinations per day for the scanner to be profitable.

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