Understanding the Lingo: What does my X-Ray, MRI or Ultrasound report mean?

Quick Guide to the Necessities 

After receiving an X-Ray, Ultrasound, or MRI, one would think that you would finally be getting the answers that you have been waiting for. More often than not, you are now left with this piece of paper that has endless amounts of technical terms, which leaves you with more questions than you had in the beginning! This would be enough to throw anyone into a panic. However, do not panic any longer! Here is the basic guide to understanding your imaging report. 

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MRI of a low back (side profile) (What am I even looking at!?) 

MRI of a low back (side profile) (What am I even looking at!?) 

A few things to point out before we dive into understanding the terms:

  • Pain does not always correlate perfectly with the imaging findings. You can have hardly no findings on an X-Ray, yet be in a lot of pain, or vice versa, have minor symptoms, with significant findings on the X-Ray. Also, two people could show the same changes on an imaging report but report very different symptoms.

  • There are normal age related changes that happen in our bodies, it’s simply wear and tear on our vehicle. That being said, the older we get, the more wear and tear that will be present, and these changes often show up on our imaging reports. However, to echo the first point, that will not necessarily equate to pain.

  • It would be rare to have an x-ray/ultrasound/MRI with absolutely no findings, especially as you get older, so it is important to take all of the information with a grain of salt before becoming overwhelmed with all the things that the doctor found. 

HERE WE GO! 

The Lingo:

  • Stenosis: Narrowing of the canals in the spine. (These canals carry the spinal cord or nerves that are exiting the spinal cord, en route for other places in the body).

  • Disc Protrusion: A vertebral disc (cushion like tissue between vertebrae or bones of the spine) with a slight bulge that extends < 3mm beyond the margin of the bone (vertebrae).  

  • Disc Herniation: A vertebral disc with a bulge that extends >3mm beyond the margin of the bone.

  • Disc Extrusion: Where the inner part of the vertebral disc protrudes out into the space where the spinal cord is located.

  • Osteophytes: A bony outgrowth. Bone responds to forces by creating more bone. Where bones rubs together, or where there are a lot of forces, osteophytes are common.

  • Degenerative Disc Disease: Normal changes in the vertebral discs as you age. The discs tend to shrink, which causes a narrowing in the disc space.

  • Tendinitis: A thickening of the tendon (piece of tissue that attaches a muscle to a bone) due to a healing process caused by an injury or simply overuse.

  • Tendinopathy: Broad term that groups all kinds of issues with a tendon.

  • Calcium deposit or Calcification: When the healing process of a tendon is in overdrive or misfires slightly, calcium deposits can result.

  • Bursitis: We have bursas all over the body, 150 to be exact!! A bursa is essentially a little water balloon that acts as a cushion and lubrication at different points in the body. It can get bigger and swollen when it’s irritated.

  • Joint Space Narrowing: Between our joints we have cartilage which helps protect joints and helps the joints move smoothly. As we age, the cartilage gets worn down. On an X-Ray, the cartilage is not visible, but the amount of cartilage can be inferred by the space seen between the bones.

Other Facts:

  • X-rays are not ideal for soft tissues (muscles, ligaments, tendons, etc.). They are more ideal for obtaining images of bones.

  • Ultrasounds and MRI are better for looking at soft tissues compared to X-Rays.

  • If you took 100 people between the ages of 20 and 80 WITHOUT BACK PAIN and did an MRI of their back, 64 of them would have some visible disc bulge in at least one area of their back, ranging from a minor disc bulge to a disc extrusion.

Obviously, there could be books written on the understanding of imaging results, however, I tried to hit some of the common themes that may come up. Take this as a starting guide into educating yourself regarding your health.

Courtney Postma, Physiotherapy Resident

Courtney Postma