Imaging and Diagnostic Tests

Finding the right treatment starts with finding the right diagnosis, and that usually means imaging. Depending on your symptoms, Dr. Grunch may order one test or several. Each one shows something different.

This guide explains each test in plain language: what it is, what it shows, why it is ordered, how to prepare and what to expect. Choose a test below to learn more.

• MRI: the most detailed look at discs, nerves, the spinal cord and the brain, with no radiation
• MRI with and without contrast: adds a dye to show tumors, infection, inflammation and scar tissue
• CT scan: the best test for bone, fractures, fusions and hardware
• Spine X-rays: show alignment, movement and hardware while you stand, including flexion-extension and full-spine films

• CT myelogram: dye in the spinal fluid outlines pinched nerves; used when MRI is not possible or not enough
• CT cisternogram: helps find the source of a spinal fluid leak at the base of the skull
• Lumbar tap test: removes spinal fluid to see whether walking improves in normal pressure hydrocephalus
• Discogram: tests individual discs to find which one is causing back pain
• Nociscan: an MRI-based test that helps find painful lumbar discs without needles
• SPECT/CT scan: pairs a bone scan with a CT to pinpoint which part of the spine is most active and may be causing pain

• DEXA scan: measures bone density before spine surgery or after a compression fracture
• Bone scan: shows new fractures, inflammation, infection and tumors in the bones

• EMG and nerve conduction study: tests how nerves and muscles work to find where a nerve is pinched or damaged

• CT and MR angiogram: scans of the blood vessels in the brain and neck
• Cerebral angiogram: the most detailed look at brain and spine blood vessels, using a catheter

• PET scan: shows how active cells are, to look for cancer spread or tumor activity
• MR spectroscopy: measures brain chemistry to help tell tumors from infection or radiation changes

• Bring a list of your medicines, including blood thinners and diabetes medicines.
• Tell the imaging center about any implant, such as a pacemaker, spinal cord stimulator, pain pump or shunt, and bring your device card.
• Never stop a blood thinner on your own. Ask the doctor who prescribes it and the doctor who ordered your test.
• Tell them if you might be pregnant or are breastfeeding.
• Ask for a copy of your images on a disc or through an online link, and bring it with the report to your visit. Dr. Grunch reviews the actual pictures, not just the report.
• If you are anxious or claustrophobic, let us know before the test so we can help.

Why does Dr. Grunch order more than one type of scan?

Each test shows something different. An MRI shows nerves and discs, a CT shows bone, X-rays show alignment while you stand, and nerve tests show how nerves are working. Together they give the full picture needed to choose the right treatment.

Do I need to bring my images to my appointment?

Yes, if your scans were done outside our office, bring the disc of images and the written report. Dr. Grunch reviews the actual pictures to match them with your symptoms and exam.

Which tests need someone to drive me home?

Tests that use a needle in the spine or sedating medicine, such as a CT myelogram, CT cisternogram, lumbar tap test, discogram or cerebral angiogram, need a driver. So does any test where you take medicine to help you relax.

Which tests use radiation?

X-rays, CT scans, CT myelograms, cisternograms, DEXA scans, bone scans, SPECT/CT scans, PET scans and angiograms use radiation, usually at low doses. MRI, Nociscan, MR spectroscopy and EMG do not.

If you have questions about a test Dr. Grunch has ordered, call 470-293-9800 or contact us. You can also ask general questions any time through our “Ask Us Anything” chat.

Related: Conditions we treat · Procedures we perform · Patient resources

This information is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk to your provider about your symptoms and follow the instructions from your imaging center.