Diagnostics
MRI and CT: which imaging answers which question?
‘Shouldn’t I have an MRI just to be on the safe side?’ This is an understandable question, especially when symptoms persist or an older report seems unclear. But different imaging methods answer different questions, and more images do not automatically mean greater clarity.
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Understanding
A closer look
At OrthoCoast in Wolgast, further imaging begins with a medical question. We do not perform MRI or CT scans on our own equipment at the practice. If an examination is appropriate, we arrange it externally and then interpret the images and report alongside your symptoms and clinical findings.
MRI and CT are not interchangeable
Magnetic resonance imaging, or MRI, shows soft tissues in particular detail. In the spine, these may include discs, nerve structures, ligaments and bone marrow; at joints, they include tendons, ligaments, cartilage and other soft tissues. MRI does not use ionising X-ray radiation. However, the strong magnetic field means that implants, devices or metal in the body must be reliably disclosed beforehand and checked for compatibility.
Computed tomography, or CT, uses X-rays and shows bony structures in considerable detail. It can be important for certain fractures, complex bone changes or specific planning questions. Which examination offers greater benefit is determined by the particular medical question, not by a general ranking. Sometimes X-rays or ultrasound provide the more appropriate first answer.
Why the examination comes before the image
Imaging reports often describe several changes. Not all of them cause symptoms. Without a discussion and examination, there is a risk of placing too much weight on a striking term while the actual problem lies elsewhere. We therefore first ask about how the symptoms developed, activity and loading, radiating pain, strength, sensation, accidents and previous treatments.
This context defines the question for radiology. Does it concern a nerve root, a tendon, a recent fracture, a specific detail of bone structure or planning the next step? An examination should be chosen so that its result can influence a decision. Repeat images without a new clinical question are not automatically useful.
Further information
How we arrange an external scan
If an MRI or CT scan is indicated, you receive the necessary referral or the information agreed with you for a radiology provider. Appointments, the scan and any decision about contrast agent are handled there according to their medical and organisational procedures.
After the scan, please bring the image data and written report to your follow-up discussion. We review the MRI images ourselves and discuss them with you. Together with the radiologist’s report and physical examination, we clarify whether the findings explain your symptoms, whether anything needs further investigation and what this means for treatment.
Making good use of existing images
Bring older images if they cover the same body region. Changes over time can often be assessed more effectively when the original image data are available as well as the reports. A CD, online access supplied to you or another transfer method used by the radiology provider may be suitable. Do not send medical image data through insecure channels without being asked.
Note the date and location of the examination. If you already have several reports, you do not need to choose ‘the right one’ yourself. We place the documents in their chronological and medical context. An older report is not worthless simply because of its age; what matters is whether it can still answer the current question.
What to expect and next steps
What to tell the team before MRI or CT
Give the radiology provider full information about implants, pacemakers or other medical devices, metal in your body, previous operations and a possible pregnancy. If you have claustrophobia, mention this when arranging the appointment. Whether contrast agent is needed depends on the clinical question; it is not automatically part of every MRI or CT scan.
If contrast is being considered, further information may be relevant, such as previous reactions, kidney function or certain conditions. Follow the preparation instructions from the radiology provider carrying out the scan. Do not change your medicines or food intake solely on the basis of general internet information. The explanation you receive there relates to the specific procedure planned.
What matters for your decision
Doctors, costs and the next step
Your doctors for arranging and interpreting further imaging are Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling and Björn Weidemann. Dipl. med. Matthias Dallmann also takes on these tasks as part of individually arranged locum cover.
Whether and to what extent your insurance covers an external examination depends on the indication, referral or prescription, insurer and provider. Binding cost information for external MRI or CT services therefore comes from the responsible provider or your insurer. If OrthoCoast itself offers a service not covered by German statutory health insurance (GKV) as a self-funded service, our written cost procedure applies before it is provided. To get started, describe your concerns through ‘Appointments & enquiries’ rather than booking ‘an MRI’.
Our doctors in this specialty
Priv. Doz. Dr. med. habil.Richard Kasch
Specialist in orthopaedics and trauma surgery
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Dr. med.Christoph Jährling
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
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Björn Weidemann
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileHere you can see the doctors who interpret your findings. Together, we discuss what the results mean for your ongoing treatment.
Frequently asked questions
Do I always need an MRI for back pain?
No. Whether an MRI is useful depends on how the symptoms have developed, examination findings, warning signs and what difference the result would make.
Which is better for bones: CT or MRI?
CT shows fine bone detail particularly well. MRI can also show bone marrow and soft tissues. The right examination depends on the specific question.
Is contrast agent used for every MRI or CT scan?
No. The decision depends on the body region, the clinical question and your individual circumstances. The radiology provider performing the scan will explain this to you.
Is the written radiology report enough for the appointment?
If possible, please bring both the written report and the image data, along with older images for comparison. We review the MRI images ourselves and discuss how the findings relate to your symptoms.
Your next step
