MRI Archives - DOC

#861 Chronic stress reaction versus acute on chronic stress reaction in a runner

I just had a consultation with a runner who had foot pain that she thought might be a stress fracture that had been coming and going for about a month.

She had been increasing her training volume and doing strength exercises that are supposed to build her running fitness.

The pain seemed to be volume related. The more training she did, the more she would notice the discomfort in her foot.

But when we x-rays of her foot, the radiologist suggested this could be an “acute on chronic” stress reaction.

What does that mean?

What is the difference between a chronic stress reaction, or an acute on chronic stress reaction in a runner?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#859 Difference between MRI vs MRA in runner with ankle injury

Let’s say you had an ankle injury a long time ago.

You sprained the ankle when you were out on a trail run, it got better , and you went right back to running.

But over time, you slowly got more and more pain in the ankle.

In that case, you doctor might order an MRI of your ankle, or a similar imaging study called an MRA (instead of MRI).

What’s the difference between MRI or MRA in a runner with an old nagging ankle injury?

That’s what we’re talking about today on the Doc On The Run Podcast.

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#845 What is hyperemia in medical imaging of shin splints?

I recently saw an elite runner who had what he thought was shin splints. One of the findings on the MRI report was something called “hyperemia.”

He asked me:

“What does that mean? Does that mean I have a stress fracture? Does that mean I have shin splints?”

What does hyperemia mean when you see it on an MRI report or an ultrasound report and you have something like shin splints or a tibial stress reaction?

Well, good question and that’s what we’re talking about today on the Doc On The Run Podcast.

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#825 Best imaging study to assess non-union stability

If you get a metatarsal fracture and it does not heal, doctors call it a “non-union.”

Sometimes, even if you have a non-union you can still run. Maybe without surgery.

The single most important consideration with a non-union is stability.

The more stable the bone is, the more likely the fracture will heal.

The more stable the bone is, the less likely it will cause pain.

The more stable the bone is, the sooner you can start running.

The more stable the bone is, the less likely you will need surgery.

One of the keys to deciding when it’s actually healed enough has to do with that stability. When it comes to assessing it, everybody wants an imaging study.

What’s the best imaging study to assess non-union stability when you have a fracture?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#815 3 ways to tell if a fracture non-union is stable without imaging

This episode comes from a discussion I called with a runner who called me for a second opinion. She had a stress fracture non-union and somebody had remained recommended that she have surgery.

I was looking at her CT scan and she asked me an interesting question.

She said,

“Does it look stable?”

And I said, “Can’t tell.”

It looks like a non-union. It looks like it’s broken and never healed.

What are the three ways you could tell whether or not a metatarsal fracture non-union is stable without getting an imaging study?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#755 Can MRI miss a plantar plate strain?

Plantar plate injuries are very common, and they are extremely annoying.

I get lots of questions and comments both from the podcast and from the Doc On The Run YouTube channel about plantar plate sprains.

Today’s episode comes from a question posted by Jason on the Doc On The Run YouTube channel. He asked…

“Can MRI miss a plantar plate strain?”

The short answer is yes, and I’m going to try to explain why.

Can an MRI miss a plantar plate strain?

Well, that’s a great question and that’s what we’re talking about today on the Doc On The Run Podcast.

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#731 Running allergy and injury recovery

Have you ever been to the doctor and heard this, “You must be allergic to running because you get injured every time you go running.”

A recovering runner and I were on a call talking about how she could get back to running and how to “just go for a run” without getting re-injured.

We were talking about this approach of getting her running fitness back now, and returning to running faster without just sitting around waiting.

She told me something I had never heard.

Today on the Doc On The Run Podcast we’re talking about running allergies and injury recovery.

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#705 Does the plantar plate need to “heal” on MRI before I can run?

Plantar plate ligament sprains are a tough injury for runners. Plantar plate tears can cause a lot of pain in the ball of the foot. Unless you treat them correctly, that pain can persist for a long time. As a result plantar plate injuries can be super frustrating.

Unfortunately, plantar plate tears are often diagnosed when you get an MRI of the foot. I often get questions from runners asking me whether or not they have to wait for another MRI before they can run.

Does the plantar plate ligament need to heal on an MRI before I can run?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#678 MRI essentials for runners, slice size matters

If you recently got an MRI and then looked at the MRI report, it may seem like a bunch of gibberish.

What you really want to see is a picture of the actual injury.

So you do the most reasonable thing…you try to look at the actual MRI images to see if you can see the stuff mentioned in the report.

You put your MRI disc in your computer, or you go on an online viewing portal and you pull up your MRI images to try to make sense of it.

You’re trying to figure out if it really picked up your injury or not.

Did the MRI miss my plantar plate sprain?
Can the MRI show me the actual crack in the bone?
Where is the tear in the tendon or ligament?

This episode on the size of the slices might help you. It will also help you a lot if you’re going in to get an MRI because you have an injury and your doctor is going to order an MRI.

Today on the Doc On The Run Podcast, we’re talking about MRI essentials for runners, slice size matters.

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#675 MRI essentials for Runners, T1 vs T2 images

If you’re a runner who got injured and got an MRI, I’ll bet that you’ve already tried to look at it…but you have simply no idea what you’re looking at.

You see there are more than a hundred images of your foot on the MRI. So, you’re not even sure where to start. MRI’s can be really overwhelming!

But MRI images are not really that complicated.

In this series on how to read your own MRI, I’m going to break it down and help you understand your own MRI images, especially if you want to see what was in the MRI report from the radiologist.

Today on the Doc On The Run Podcast, we’re talking about MRI Essentials for Runners, T1 versus T2 Images.

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