Pain in joints and the spine is widespread. They are linked to our lifestyle, lack of exercise and increasing life expectancy. Countermeasures can be taken if detected at an early stage. However, precise diagnostics are necessary to identify the causes of joint and back pain.
The detection of inflammation plays a key role in identifying the source of pain in the joints and spine. This is because inflammation is accompanied by pain. These inflammations can be identified with the help of special contrast agents and the pain-causing changes can thus be precisely localized.
Two Examples:
The cause of pain, particularly in the spine, can often not be found with conventional MRI examinations. Harmless disc protrusions, which are present in almost everyone, are often wrongly blamed for the symptoms and can lead to unnecessary operations. The actual cause, e.g. inflammation of a certain facet joint, is regularly overlooked without contrast medium, although it is easy to treat.
For Joint Injuries
An immediate MRI examination improves the success of treatment and saves costs.
If there is pain in the knee and evidence of a torn meniscus, this is usually automatically held responsible for the pain. But a meniscus has no nerves. A tear can only cause pain if it causes the meniscus to pull on its attachment to the joint capsule when the joint moves, leading to inflammation. This inflammation can be identified by the associated contrast agent uptake.
The image shows an MR contrast-enhanced image of the articular cartilage in knee joints, left (A) in a healthy individual, right (B) in a patient with osteoarthritis. The reduced index values in the articular cartilage of the diseased knee joint (B) correlate with reduced concentrations of glucosaminoglycan in the cartilage tissue and in the medial meniscus (arrows), characteristic of degenerative changes.
In other words:
A meniscus tear without contrast medium does not hurt. Treatment is superfluous. The cause of the pain is yet to be found.
More than 10 years ago, a study from England determined: patients with knee injuries (and other joint injuries) should receive an MRI scan of the injured joint as the first line of investigation. MRI provides a better image of the injured structures in the joint than a clinical examination. This allows cruciate ligament and meniscus tears in the knee to be better detected than by clinical examination. In particular, MRI can also better detect concomitant injuries, such as bone and cartilage damage, which can be decisive for the success of treatment.
