By Dr. Steve Derrington, board-certified in physical medicine and rehabilitation
A lot of patients come to me with an MRI report in hand and one question: what does it mean for me? The report matters, but it’s only one piece. Here is what I think a thorough orthopedic evaluation should include.
Why the evaluation comes first
Diagnosis is the first thing you have to get right. It takes years of training and experience to develop the diagnostic skills to determine what is actually causing your pain. That’s why I believe the person evaluating you should be orthopedic-focused, ideally a physician with that training, and not someone who took a weekend course on how to do an injection.
What should be part of the visit
A thorough evaluation includes:
- A hands-on physical exam.
- A head-to-toe conversation about your symptoms and goals.
- Direct examination of the area that’s causing your symptoms.
- Often, an ultrasound evaluation, to see in real time what’s happening to those tissues as you stress them.
Together, those pieces give you a more complete understanding of the problem than a quick look at an X-ray or an MRI report.
How the evaluation connects to treatment
When we treat very small, sometimes millimeter-sized problems, I want to see where I’m going. Depending on the problem, that means ultrasound or live X-ray, both for the therapeutic value and for safety, because some areas have blood vessels and nerves nearby.
I also look at the quality of the physical therapy you have already done and whether it was tailored to you. If you want to know what to ask any clinic, read choosing a PRP or bone marrow clinic: 3 questions to ask, and see when a nonsurgical second opinion makes sense.
Bring your imaging
If you have an MRI, you can upload it ahead of your visit. The Am I a candidate? page shows you how to find out whether bone marrow concentrate or PRP makes sense for you, and my areas treated page lists the conditions I treat.
I see patients at my Carlsbad office (5806 Van Allen Way, Suite 101, Carlsbad, CA 92008) and on Tuesdays at my Laguna Hills office (25411 Cabot Rd, Suite 116, Laguna Hills, CA 92653). You can call (760) 721-4000 or request an appointment online.
Frequently asked questions
Is an MRI report enough to know what is wrong?
No. An MRI report is one piece of the picture. A hands-on exam, a full conversation and often ultrasound give a more complete understanding.
Why use ultrasound in an evaluation?
Ultrasound lets me see in real time what’s happening to the tissues as you stress them.
Who should perform my evaluation?
Ideally, an orthopedic-focused physician with the training to determine what’s causing your symptoms.
This article is general education and does not replace an exam or medical advice for your situation. Results vary from person to person.
