Often times in your medical care various diagnostic tests may help your doctor determine the source of injury or disease. There are several options available in diagnosing a condition, each with its own set of benefits. These may include imaging studies such as x-rays, MRIs, CT scans, ultrasounds, or bone scans; a test of nerve function known as an electromyogram/nerve conduction study (EMG/NCS) or a test of brain function known as an electroencephalogram (EEG). At OrthoNeuro, you can have these services provided on-site and, if not, we can arrange these tests to be done at a location that is convenient to you.
| Electrodiagnostic Studies (EMG) |
Electrodiagnostic studies consist of both nerve conduction studies (NCS) and electromyography (EMG). These studies are often performed together and the combination of the two is abbreviated an EMG/NCS or, more commonly, just EMG. They work in combination to measure the electrical activity in nerves and muscles and are used to evaluate nerve and muscle injury. These injuries may be due to nerve compression, primary nerve or muscle diseases, or secondary injuries related to other diseases. An EMG helps your physician determine if your nerves and muscles are healthy and, if not, determine the cause of the nerve or muscle injury.
What Conditions Can the Testing Diagnose?
- Pinched nerve in neck or back (possibly related to ruptures disk or arthritis)
- Pinched nerve in the arm or leg such as Carpal Tunnel Syndrome
- Muscle disorders such as Muscular Dystrophy or Myopathy
- Neuromuscular disorders such as Myasthenia Gravis
Nerve conduction studies
Nerve conduction studies (NCS) are performed to determine how well your nerves conduct signals. The procedure involves stimulating the nerves with a small amount of electricity and recording how each nerve conducts this signal along its course. Electrodes in the form of stickers or wires record the responses of these stimulations. The electrodes are attached to a computer that analyzes the signals and produces a visual representation of them on its screen. Your physician interprets the results by making measurements of the responses and correlating them to your symptoms.
Electromyography
An electromyogram (EMG) uses a fine wire electrode to evaluate the electrical activity of muscles. Muscles are controlled by nerves and it is possible to tell if there is an injury to a nerve by evaluating how the muscles it supplies fires. In this way, muscles in the arm can be tested to identify an injury in the neck and leg muscles can be tested to evaluate an injury in the back. The fine wire electrode used in EMG is slightly larger than an acupuncture needle but not nearly as big as a hollow point needle used for blood draws or IVs. The electrode is connected by wire to a computer where the signal is analyzed and displayed as an image on the screen and broadcast as a sound, typically a popping noise heard with muscle contraction. The muscles are tested both at rest (to make sure there are not any abnormal spontaneous signals that should not be there) and then with muscle contraction (to make sure the muscle is firing normally).
What Can I Expect?
An EMG takes about 30 minutes to an hour to complete. The nerve conduction studies are commonly performed first, followed by the EMG. The electrical stimulations used in nerve conduction studies typically feel like getting a rubber band snapped against your skin. Usually, three to four nerves are tested in an affected limb and, if necessary, a few in an unaffected limb are tested for comparison. The EMG feels like getting your skin pinched with electrode insertion and may cause a dull ache, but is generally well tolerated. Generally, nine to twelve muscles are tested. Arm, forearm, and hand muscles are tested to evaluate neck and upper limb injuries. Thigh, leg, and foot muscles are used to evaluate low back and lower limb injuries. Risks of an EMG are very rare.
| Electroencephalogram (EEG) |
An electroencephalogram (EEG) is a test used to detect problems in the electrical activity in the brain. Your brain cells communicate with each other through tiny electrical impulses. An EEG measures this activity by placing electrodes on your head.
How the test is performed
You will be asked to lie on your back or in a reclining chair. 16 to 25 electrodes will placed in different positions around your scalp. The electrodes are attached to wires connected to the EEG machine which will record the impulses. The machine converts the electrical impulses into patterns which can be seen on a computer screen and saved to disk.
Why is this Test Performed?
EEG is used to assist in the diagnosis of seizures, causes of confusion, sleep disorders, and to evaluate head injuries, tumors, degenerative diseases, such as Alzheimer's Disease, and abnormal changes in the body chemistry that affects the brain.
Musculoskeletal ultrasound is the use of high frequency sound waves to visualize anatomic structures. Ultrasound is evolving as a diagnostic tool in assessing joint and soft tissue pathology. The exam is painless and allows the patient to see in real time their pathology. The procedure is done in the physician's office and usually takes a few minutes. Shoulders, knees, ankles, feet, elbows, wrists, and muscles and soft tissues may be examined. Diagnostic ultrasound is commonly used in the NFL and the Olympics. New and exciting treatment modalities using ultrasound are being investigated for plantar fasciitis, tennis elbow, and Achilles tendonitis to name a few. Many times a diagnostic ultrasound may be used in place of an MRI. Diagnostic ultrasound is a developing technology that aids the physician in his decision to best treat the patient.
Who are the Physicians at OrthoNeuro that perform Diagnostic Studies Testing?
EMG/ Nerve Conduction
Christopher Cannell, MD
Robert Mazo, DO
Scott Otis, MD
Michael Simek, DO
Thomas Skeels, DO
Martin Taylor, DO
Stephen Woods, MD
Emily Yu, MD
EEG
Robert Mazo, DO
Francis O'Donnell, DO
Martin Taylor, DO
Diagnostic Ultrasound
Jeffrey Gittins, DO
Mark Gittins, DO
Other Medical Imaging
Diagnostic X-rays provide the physician with detailed information they can use to determine the best plan of treatment for your medical condition. X-rays are electromagnetic waves that can pass through the body to create an image of the internal structures being examined. Soft body structures are less dense and appear darker on x-ray. Because bones have more density, they absorb or block more radiation and appear light or white on an x-ray. X-ray imaging can be used to diagnose fractures, bone irregularities, and irregularities, such as arthritis in the joint space between bones.
OrthoNeuro has X-ray services available at all of our main locations.
 Magnetic Resonance Imaging (MRI) is a safe, non-invasive way for your physician to look into your body. The exam uses radio waves and a magnetic field to create images of the soft tissues and bones of the body and provide information that can improve your diagnosis.
MR Images look a lot like a conventional x-ray; however, they provide much more detailed information. The images will be provided to your physician or radiologist for interpretation.
How is the MRI Performed?
You will be asked to lie on a table and the technologist will position you comfortably. The table will be slid sideways into the open magnet. In most cases, only the extremity being imaged will be in the magnet.
What Can I Expect?
 You won't feel anything throughout the scan; however, you may be in some discomfort at the time of your exam due to your pain. You will hear a muffled rumbling and/or a slight knocking sound.
How Long Will the Exam Take?
The complete exam takes 45-60 minutes.
OrthoNeuro has an extremity MRI unit at our Westerville Office. Our staff can assist in scheduling an appointment at our facility or another site convenient to your home if your physician requests an MRI be taken.
Computed tomography (CT) is a non-invasive medical test that assists the physician in diagnosing and treating medical conditions. A computer converts two-dimensional x-ray cross-sectional images into three-dimensional "slices" of the body part. CT scans of internal organs, and soft tissue provides greater detail and clarity than regular x-ray.
Your OrthoNeuro physician may request a CT scan to diagnose problems in the spine, small bones in the extremities, and other soft tissue structures. They may also used to test bone density when evaluating for osteoporosis.
How is the CT scan performed?
The technologist will place you on the exam table in a position appropriate for your medical condition. Straps and pillows may be used to assist you in maintaining the test position. The table will then move quickly through the scanner to detect the correct starting position. Then the table will move slowly through the machine while the scan is completed. You may be asked to hold your breath during the scan. Even small movements such as breathing can distort the image.
Following the scan, you will be asked to wait until the tech verifies the images are high enough quality for accurate interpretation. |
