A foot-and-ankle orthopedist told me I need to get a stress x-ray of my ankle.
I arrived at the specialty lab which does radiology - nuclear medicine (MRI, Bone Scan, etc.) and the whole works.
The guy who did my “stress x-ray” told me he asked two other technicians and he guesses they don’t do this kind of thing often. He definitely made it up as he went along, and I even suggested a few different views to him which he accepted.
He also pronounced oblique with the ike sound from “bike” … I understand that’s an alternative pronunciation for the word, but it’s still weird.
Also, although my primary care physician has an x-ray lab in their facilities, they do not take stress x-rays there. Not sure why, because all this guy had me do was stand so that my ankle was torqued one way or another.
I had one of these done for my knees about 27 years ago after an incident with a skateboard. It involved having my thighs strapped together and x-rays taken while the doctor pulled my feet apart. My left knee bent out at a 15° angle. The pain was extremely extreme - I literally saw stars and explosions. Not only did the sadistic SOB pull my legs apart, he held them that way for a subjective year or two while they took the x-rays. I’m happy for you that your experience was not as painful.
We regularly take “stress” views of various joints–usually the knee. They’re generally used to view the instability of a ligament or maybe an avulsion fracture in an ankle (not too uncommon, unfortunately).
Of course, the body part that needs stressing is usually hurting, so oftentimes we make the doctor that ordered it do the holding.
Sometimes they can be a bit ad libbed depending on what/where the injury is.
If the tech just receives an order that says “Stress views right ankle” and the doctor that ordered it isn’t available, well, we just do what we can based on what the patient tells us.
Me…I’d just take one or two standard (non-stressed) views first to see what I’m dealing with before moving forward.
10 years ago, I had an avulsion fracture. The anterior talofibular ligament was destroyed (grade 3 sprain, fully ruptured, now missing), causing avulsion on both the lateral and medial malleolus. All of this was known before the x-rays.
I’ve never had an x-ray where the technician (and, if other people are around, all other people) don’t leave the room to get behind a radiation shield. This technician was very hands-off, and would just vaguely describe what he wants me to do. Then he’ll say “Perfect, hold that” and rush off to press the x-ray button.
This is a specialty imaging place. Referring doctors are never in this building.
Exactly what he did: He had me take one ob-like view (his pronunciation of oblique), and one slight-angle view, then four “stressed” views. I wanted to get another 4 or 6 stress views and angles, but the technician seemed to think we were done after 3. I suggested one more and he took it.
I’m guessing the doctor is going to look for bone placement and guess what is going on based on that? As far as I can tell from the MRI report I got a few months ago, this is mostly soft-tissue, which doesn’t show up on x-rays. So, he must be looking for something by inference?
Yes. By looking at how far apart the bones move when stressed you can tell if a ligament or tendon is not doing it’s job in holding the bones where they should be.