BACK PAIN

Majority of the people experience back pain in sitting posture or while standing and only very rarely they experience pain in (recumbent) lying down position. But almost everybody will have exaggeration of the pain in vertical position. This makes sensitive to scan the patient with back pains in vertical position. Conventional MRIs whatever be the tesla strength cannot scan a patient in standing or sitting posture. The simple dictum is that a scan taken in painless position can not show the cause of pain.
Supra’s G-Scan with its tilting design allows the patient to be scanned in any posture lying down, sitting, standing and slanting position.
Majority of the back pain are discogenic with a huge chunk of these due to degenerative disc disease…. (DDD). Unlike a normal disc, degenerative disc collapses with the weight of the body only in sitting or standing posture (vertical position).

NECK PAIN

Majority of the people with neck pain experience it on sitting for long time(office work, watching TV for long time) all in vertical position only weight of the head falling on the degenerated disc results in collapsing of the degenerated disc is the main cause for the pain. Few people experience pain only during bending backward or forward. Supra’s G – Scan allow the kinematics study and is most ideally suited for neck pain.

SCIATICA

The running pain along the legs starting from the buttock downwards is commonly referred to as sciatica. The major cause for sciatica is a prolapsed disc, disc bulge, osteophyte pressing upon the nerve roots which supply the muscles and skin of the lower limb. Body weight acting upon the disc in vertical position makes the amount of pathology more appreciable in standing/sitting position. During recumbent posture (lying down) as there is no weight acting on the disc, the prolapsed or the bulge minimizes or disappears. So the vertical MRI is best suited for examinations of patients with leg pain, sciatica and disc prolapse.

ARM PAIN (Brachialgia/radiculopathy)

Neck pain may be accompanied by arm pain. A common cause of neck, shoulder and arm pain is ruptured or herniated cervical disc, degenerative disc disease, bulging disc, spinal stenosis etc. If the disc herniates in the direction of spinal cord or nerve root it causes neurological compromise. Compression of the nerve root causes arm pain (brachialgia). Symptoms include dull or sharp pain in the neck or between the shoulder blades, pain radiating to the arm, hands, fingers or numbness or tingling in the shoulder or arm. Neck movements like bending forward, backward, sideways intensify the pain. MRI taken in these positions of pain will give a clearer picture of the pathology compared to the picture taken in neutral/relaxed position. G-Scan allows positioning the patient with the weight of the head falling on ruptured disc and hence showing the real cause of pain.

PIVD AND DISC BULGE

Prolapsed intervertebral disc affects individuals in the age group of 25-45 years. Major risk factors include frequent lifting of objects, exposure to whole body vibration, including driving motor vehicles, cigarette smoking etc. Here the disc bursts and fragments of the outer annulus fibrosus, together with some of the inner nucleus pulposus press upon ligaments and nerves running close to the disc and produce pain. Pain produced is deep, dull and persistent and may radiate. For example a prolapsed disc in the lower back may produce pain in the buttock, hip or legs. These pains are worse if person bends in one particular direction. Pain also becomes unbearable when standing straight. It isn’t uncommon for people to complain that pain worsens while sitting. If you have prolapsed disc and pain aggravates and causes trouble while standing or doing work then diagnosis of the condition should be done in the same position of pain. This is possible only with Supra’s G-Scan where scanning is done in the position of symptoms. During weight bearing position weight of the body acts on the spine causing the intervertebral disc compression and bulging. This curtails in non weight bearing position.


SPONDYLOLISES AND SPONDYLOLISTHESIS

Spondylolysis is the medical term for a spine fracture or defect that occurs at the region of the pars interarticularis. Spondylolisthesis is the medical term used to describe the forward slippage (anterior translation or displacement) of one spine bone (vertebrae) on another. Back pain is the most common presenting symptom; the predominant symptom(s) may be difficulty walking, postural deformity, and/or hamstring tightness. Adults frequently have leg pain, numbness, and/or weakness (sciatica, radiculitis, or radiculopathy) while children rarely have leg symptoms. A vertical MRI test is useful to evaluate the severity of nerve compression caused by listhesis. In gravity assisted position slippage of disc is more perfectly observed. With the body weight acting the degree of slippage is accurate as compared to the lying down position. Hence better diagnosis in tilting MRI which positions the patient in their angle of symptoms.

KNEE INJURIES

Knee is an active weight bearing joint. Causes of knee pain include injury, degeneration, arthritis, infrequently infection, and rarely bone tumors. Degeneration of the knee is caused by the breakdown and eventual loss of the cartilage. Knee pain symptoms aggravate while climbing or getting down from the stairs, getting up from a sitting position, kneeling, walking, lifting some weights, bending, putting weight on the knee etc. During weight bearing there is more stress on the knee hence more pressure on the thinned cartilage and the two degenerated knee bone ends rub together causing the symptoms. With the ability of G-Scan or tilting MRI imaging of the knee can be done in different postures giving an accurate MRI picture. Hence a better understanding of the condition with improved management is obtained.

LIGAMENT TEARS

Contact sports involve a lot of injury to the knee joint producing bony and ligamentous injuries. Sudden (acute) injuries may be caused by a direct blow to the knee or from abnormal twisting, bending the knee, or falling on the knee. Pain, bruising, or swelling may be severe and develop within minutes of the injury. Nerves or blood vessels may be pinched or damaged during the injury. The knee or lower leg may feel numb, weak, or cold; tingle; or look pale or blue. The meniscus is a wedge of cartilage within the knee joint that helps to cushion, stabilize, and transmit weight across the knee joint. When a meniscus is torn, the normal triangular appearance is disrupted. Similarly the four ligaments of the knee when injured are seen by MRI as disruption of the fibers of the ligament. Clear picture of the disruption can only come when seen or diagnosed in the same functional positions. The vertical MRI is tremendously helpful when investigating these problems of the meniscus and other knee ligaments. During full weight bearing the ligaments and other soft tissues surrounding the joint will acquire the shape in which they cause pain or difficulty walking and doing other daily activities.

ANKLE INJURIES

The ankles support the entire body weight and ankle injuries are very common. Usually, the cause is accidental (e.g., stepping into a pothole, slipping while getting out of the car). Ankle injuries usually involve a sudden, unexpected, loss of balance that results in a sharp twist of the ankle. A strain occurs when a muscle or tendon overstretches. A sprain, which is more serious, occurs when strong connective tissue that connects one bone to another (ligaments) become overstretched. Inability to walk on the ankle, swelling and pain in the foot or above the ankle are the common symptoms. Vertical MRI allows cartilage and ligament injuries to be diagnosed in full weight bearing. In this position the actual displacements and degree of ligament tears can be observed. Compared to the lying down position where the ankle is at rest and in neutral position ligaments are laxed hence the severity is misse4d. Thus vertical MRI is the best option for knowing the pathologies and tears in ankle.