You’ve done the hard part. You went in and had the MRI (or other imaging test) your physician ordered. You paid your co-pay, waited patiently for your name to be called, laid still during the exam, and it’s all over. So now what? How can you get the most out of your radiology results? (Hint: the answer is not to sit passively). Here I am going to discuss the steps you can take to take greater control of your imaging and help it become as useful as possible for you and your physician.
1. Get a copy of your report. Within a few days of your exam (and often within minutes or hours), your exam will have been read and interpreted by a radiologist. He/she will issue a formal report that your treating physician will see and use to help make treatment decisions. As I’ve mentioned in previous blogs, these reports can be hard to understand. But again, there are things any lay person can use to help decipher the code, and sometimes input by you as the patient can help to add clarity to certain issues. Was the radiologist provided with the appropriate history? Was the current exam compared to any prior imaging studies I may have had? Does the Impression section explain why I have the symptoms I have?
It is now easier than ever to get your report. As part of the Affordable Care Act, clinics and hospitals are increasingly being required to provide a patient portal where you can log in and see results like lab data and other results. This allows you easy access to your radiology report. If you don’t have access at the moment, you can always go to the center where the imaging was performed and ask for a copy of the report. Or it is sometimes easier just to ask the office that ordered the test for a copy.
2. Be a little inquisitive. When you meet with your physician, ask questions! Does this test explain my symptoms? What did the radiologist mean when he said that the muscle was atrophic? Do I need to get another test?
Also, consider looking at your images yourself. It’s easy to get a CD of your imaging and they usually come with a viewer where you can load your study on any computer. Sure, it might feel like the equivalent of reading sanskrit but how can it hurt? If nothing else, looking at the pictures may give you a greater appreciation for just how complex and elegant radiology can be!
3. Keep track of your imaging history. Are you one of those patients who keeps a meticulous list of your medications that you can pull out of your purse or pocket at a moment’s notice? Well, I can tell you this is actually very helpful for your physician and treatment team. Physicians train for many years to be able to synthesize large amounts of information quickly but things like uncertainty over actual medications and imaging can muddy the waters of the mind.
So every time you have an imaging test (x-ray, CT, ultrasound, MRI, nuclear medicine exam), record it in a log: Type of test, date, place, side. The side of exam seems sort-of obvious but 5 years after a knee injury, it can be very hard to remember: was that x-ray and MRI of my right knee or my left?
Here’s another example of how keeping a log helps: A 61-year-old woman presents to her doctor with a three day history of cough and fever. Her physician orders a chest radiograph that is normal other than a 17 mm nodule (about the size of a dime) in the left lung. Depending on the appearance of the nodule—I won’t get into that here—the radiologist may recommend comparison with a prior exam if none are available, or a chest CT to further evaluate the nodule. The woman consults her log and it jogs her memory that she had a chest radiograph 7 years earlier when she lived in another state. She subsequently gets a copy of that imaging, the radiologist looks at it and is able to concretely state that the nodule is unchanged and therefore very likely to be benign. The woman no longer needs the chest CT—having knowledge of the previous exam has saved the patient the worry leading up to the CT, not to mention the expense!
The healthcare system is still not well adept at having your medical information follow you from place to place (although it is getting better). Keeping track of things in your head can be difficult, especially if you have tests in multiple locations in the same city, or have moved recently. The log helps solve this issue.
4. Strive to be a model patient. Okay, this is sort of a general remark but it is definitely true that a prepared, organized patient often gets better care. If you take the time to get your report, read it, and come up with questions for your physician, this can help spur a discussion that may hone in more quickly on your diagnosis.
5. Consider communicating directly with a radiologist. Now believe me, I am not saying to circumvent your own physician. But occasionally, there are imaging findings that are best explained by an imaging expert. Having a radiologist describe the findings directly can be very powerful. Even better, if you get a chance to have the imaging findings shown to you by the radiologist, it allows you to understand what is going on in your own body. This can be very empowering.
A direct consult with a radiologist can help clarify points. For instance, say you have an MRI of your lumbar spine (the lower back) and the report describes multilevel degenerative changes and describes several disc bulges. You may not have gotten a great sense from your physician of which if any of these problems is causing your pain. The radiologist may be able to listen to your symptoms and pinpoint the exact cause (like, say, a foraminal protrusion compressing an exiting nerve root). Armed with this knowledge, you could then speak with your physician about treatment options like physical therapy, epidural injection, surgery, etc.
I hope you have found these simple hints to be helpful in coming up with a game plan for what to do after you’ve had an imaging test. Some of these suggestions may seem like small things, but in medicine, it is often the little things that make all the difference.