Radiologists: There’s More Than One Way to be Stabby!

Never again, Radiologists. Never Again.

Never again, Radiologist friends. Never again.

I woke up at two PM today after a very long day yesterday. Long, but also more pleasant than I’d anticipated, all things considered. I did, after all, have a date with a humongous needle.

The following post is a public-service announcement for radiologists, as well as anyone and everyone who needs to have an MRI Arthrogram on their hip in the near future, be you athletic, arthritic, or accident prone. My radiologist took a very different approach to the procedure. Instead of entering vertically, he went in horizontally. While I was initially skeptical (read: ready to bolt out of the room), his technique was much less painful than the standard method. I never want to have a “normal” hip MRA again.

I am NOT a radiologist, and I'm sure I have the angle wrong, but I also pay VERY close attention during these procedures. This is my best approximation of the approach that my Radiologist took.

I am NOT a radiologist, and I’m sure I have the angle wrong, but I also pay VERY close attention during these procedures. The blue line is my best approximation of the approach that my Radiologist took.

As I mentioned in my last post, the standard operating procedure for performing an MRA on the hip involves sticking a really big needle into the patient’s groin. This sucks for several reasons.

Even though your radiologist has magical x-ray vision to guide you, because she or he is entering vertically, their margin for error goes up. I once had a radiologist wiggle a needle that was a good six inches inside of me because he realized he hadn’t quite hit the spot he needed to.

By entering horizontally, the radiologist was able to do that guess work ahead of time. He had me lay on a “pointer.” Instead on manipulating a needle, he manipulated that pointer, until the x-ray showed that he’d found the right angle to get where he needed to go. After that, all he had to do was match the angle of entry laid out for him.

Standard hip MRAs also suck because…. you’re sticking a needle in a human being’s groin. If you had to stick yourself with a needle, would you rather stick it in your stomach or your arm? Answer’s pretty simple right?

I was worried at first that going in from the side of my hip would mean travelling through more muscle, and—since the tear they’re looking for is on the groin side of the hip—reduce the likelihood  of the dye actually illuminating the part of the acetabulum that needed seeing. The latter concern won’t be fully assuaged until I get my results, but the former… that was pretty instantaneous. A giant needle in the side of your hip is less painful than a giant needle in your groin, period.

Now that I’ve had this procedure done both ways, I can say with certainty that it takes longer to recover from the MRA if you enter through the groin. While this new approach caused a different kind of pain (a pain with which I was unfamiliar, and therefore unprepared for) it was easier to walk immediately following the procedure. Today, instead of feeling like I have a water balloon in my groin, I feel a soreness that, if unpleasant, is certainly more bearable. It just feels like my side is a little tender, a little swollen. It’s pain, sure, but it’s not exactly going to ruin my day.

I was terrified when I first realized I was going to be worked on by a “rogue radiologist,” so I asked him why he opted for this non-traditional approach. His response was very heartening. To paraphrase, when he began practicing, he realized that he’d only ever been taught by radiologists, and that there may just be other doctors out there who knew things he didn’t. So he sought out orthopedic surgeons and asked them at what point of entry patients feel the least pain, and changed his approach accordingly.

THIS. SHOULD. NOT. BE. AN. EXTRAORDINARY. STORY.

And yet it is.

No radiologist in their right mind is going to change the way they perform a hip MRA because their patient walks in holding a copy of my blog post, but I want to encourage people to circulate this post to their doctor friends, and especially their radiologist friends. If even one doctor finds themselves moved to have a conversation based on this story, than this post was 100% worth my time.

 

“The Six Million Dollar Scholar” is the personal blog of Andrea Milne, a Ph.D. candidate in modern U.S. History at the University of California, Irvine. To get the story behind the blog’s name, click here.

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