Imaging in the position that causes pain

John W. Gilbert, Greg R. Wheeler, Richard A. Lingreen, Robert K. Johnson, Steven J. Scheiner, Richard A. Gibbs, Shailesh P. Upadhyay, Kwadwo Gyarteng-Dakwa

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Magnetic resonance imaging has the diagnostic advantages of being noninvasive and able to visualize soft tissue. However, conventional recumbent MRI may underestimate a disease because the position of imaging takes stress off the spine. Case Description: A 37-year-old woman presented with complaints of pain in the neck that radiated down her right arm when she turned her head to the right and increased with extension. She complained of paresthesias, numbness/tingling in the index and middle fingers and thumb, in the C6 and C7 nerve root dermatomes. Conventional conservative measures, including anti-inflammatories, muscle relaxants, opiates, and physical therapy, had been tried without positive results. Magnetic resonance imaging was performed in a weight-bearing upright neutral position, in the extended upright position, and in the extended upright position with the head turned to the right. The latter images showed a clear protrusion at C5-C6 and C6-C7. These protrusions were not clearly evident in the upright neutral position. A targeted epidural block at C5-C6 and C6-C7 relieved the patient's pain, and she has been able to continue work. Conclusions: Magnetic resonance imaging of the cervical spine in the position that causes the patient's symptoms may increase the sensitivity and accuracy of the diagnostic study and thus provide the spine-care professional with a potentially more accurate diagnosis and a targeted treatment plan. Such MRIs may also decrease the need for myelography.

Original languageEnglish
Pages (from-to)463-465
Number of pages3
JournalSurgical Neurology
Issue number5
StatePublished - May 2008


  • Diagnostic imaging
  • Functional magnetic resonance imaging
  • Intervertebral disk
  • Spine

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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