This article first appeared in the February 2019 issue of Lifelines, the Life West student magazine. Jonathan Hooker is the editor and designer of Lifelines.
Diagnostic imaging is our window inside the body, a fascinating and extremely powerful one. Since the advent of X-ray imaging in 1895, the ability for health professionals to assess the body has grown tremendously. Since X-ray imaging became commonplace, we have strived for more complete forms of imaging and have developed more methods of viewing inside the body. These include:
- Nuclear imaging, which is typically used to find areas of increased cellular metabolism as seen in metastatic disease via a radiotracer
- Computed tomography (CT), which uses many low-power x-rays from different angles to produce a volumetric image of the body
- Magnetic resonance imaging (MRI), which uses changing magnetic and electric fields to produce volumetric images of the body
- Ultrasound (US), which uses sound waves to produce images in localized areas within the body
All these modalities grant us a wide array of possibilities for observing the body, each with their own positives and negatives. Leveraging the strengths of these imaging techniques, while clearing our minds, can lead to a lot of insight about your patients. If you do not have a clear mind, or if you start looking for something specific, you can unintentionally blind yourself to more findings that may be in the image or images. Furthermore, once you do find what you are looking for, it can be all too easy to stop looking at that point, when there is more to discover within the image or images.
In the greater radiology community, it is thought that when someone is looking through an image set, once something is found, you tend to stop looking or at least looking as carefully. This is a reminder about why it is important to keep your mind open, and to prevent yourself from getting tunnel vision.
With how much diagnostic imaging can potentially reveal, you can easily get lost. It can be quite daunting to try and interpret the images. This, unfortunately, leads to fear about missing a finding for chiropractors who would likely use diagnostic imaging in their practice, but ultimately decide not to. This should not be a factor that dissuades you from getting imaging done on a patient, but rather should be seen as an opportunity to learn, understand, and see just how much variation there is between individuals. Furthermore, if you are truly concerned with missing something critical, DACBR’s, outside imaging centers, and radiologists can help interpret the images if you do not feel confident enough to interpret the images yourself. Diagnostic imaging, when done appropriately, can give valuable insight to the status of your patients, allowing you to know what spots may need the most care, and which spots to avoid, if any.
The ability to observe inside the body affords us the ability to identify non-palpable findings and contraindications to adjusting the patient. This is a critical observation if you are going to be moving structures within the body, not only to prevent injury, but to give the best and most precise care for where the patient needs it the most. It will help give you insight into where a problem may lie, especially when your palpatory findings or even the patient history are not giving you a clear enough picture on their own.
And, again, it is important to not let yourself get lost in the details or fixated on something specific you are looking for. We want to ensure we do not blind ourselves to something that is plainly before us. Keeping your ability to observe unimpeded is of utmost importance!
Life Chiropractic College West agrees with Jonathan’s perspective on the use of imaging in chiropractic care. For more on that topic, read this post: “Life Chiropractic College West Responds to the ACA’S ‘Choosing Wisely’ X-Ray Campaign.”