Click Here to Read the Article from the American Journal of Physical Medicine & Rehabilitation.

Platelet Rich Plasma

HARNESSING YOUR BODY’S NATURAL HEALING POWER
The body has an amazing capacity to heal itself. When the body becomes injured, a natural healing process occurs to repair the damaged tissue. The body signals platelets and other components in our blood supply to migrate to the site of injury. Under normal conditions, these platelets release a variety of factors that initiate and subsequently promote healing. New advances in medicine have been developed to harness and concentrate these platelets to be precisely introduced to the injury site in an injectable form. The implantation of these platelets from a small amount of the patient’s own blood has the potential to “supercharge” the body’s capacity for healing.

WHERE IS PLATELET-RICH PLASMA BEING EVALUATED?
Many active patients are familiar with repetitive or overuse injuries that can cause micro tears of the muscle and/or tendon fibers, resulting in weakness and pain at the injury site. This is commonly referred to as tendonitis, which is an acute inflammatory condition, or tendinosis which is a chronic degenerative condition. Both conditions can be categorized as tendinopathy and can affect the normal healing process of the damaged tissue which can lead to pain and dysfunction. Recent studies have evaluated the use of Platelet-Rich Plasma (PRP) to address these conditions. A double blind, randomized controlled trial evaluated the use of PRP for chronic lateral epicondylitis (tennis elbow) which resulted in reduced pain and increased function, exceeding the effect of the group treated with a corticosteroid injection.1 Another study evaluated the use of a single PRP injection in patients with painful medial or lateral epicondylitis for at least 6 months that were unresponsive to other nonsurgical (conservative) treatments, including a corticosteroid injection.
The results suggest that a single PRP injection can improve pain and function in patients who failed other types of nonsurgical treatment, thus avoiding surgery.2 Other studies have evaluated the use of PRP for chronic Achilles tendinopathy, chronic Plantar Fasciitis and Patellar tendinosis also known as Jumper’s knee.3, 4, 5 It’s important to speak with your treating physician to learn more about the studies that have been published evaluating the use of PRP for tendinapothies.

PROCESS FOR RECOVERING PLATELET-RICH PLASMA
A very small amount of blood is drawn from the patient into a sterile tube in the exact same manner as a standard blood sample. The tube containing a patient’s blood is placed into a centrifuge and spun to separate the platelets from the other blood components. After a few minutes, the concentrated platelets are removed from the same tube and re-introduced into the patient at the site of the injury. Using a sterile needle, your physician will inject the PRP in and around the injury site. This is all accomplished without using any animal products or other foreign material.

NON-SURGICAL TREATMENT APPROACHES TO UNRESPONSIVE INJURIES
Patients who are interested in exploring non-surgical treatment options before resorting to surgery may want to consider PRP. Traditional non-surgical interventions include: Corticosteroid (“cortisone”) injections, oral anti-inflammatory medications, exercise and bracing. In many cases these modalities may not cure the condition, whereupon PRP may potentially be of great benefit.1 Before you can be considered a candidate for PRP, a complete examination must be performed by your treating physician. This will include a physical examination and diagnostic evaluation. Prior to treatment, you may be asked to refrain from taking non-steroidal antiinflammatory drugs (NSAIDS) for a week. Following the PRP treatment, some localized soreness may occur, which is typical of any injection. This can be addressed with ice, heat, or elevation as well as with
acetaminophen. Physical therapy may be prescribed.

IS PLATELET RICH PLASMA THERAPY SAFE?
For over twenty years, PRP has been used in many different fields of medicine including: cardiac surgery, oral surgery, dentistry and periodontal implants, orthopaedics, wound care, sports medicine, neurosurgery, general surgery and cosmetics.1 Research and clinical data show PRP derived from the patient’s own blood is safe, with minimal risk of adverse reactions or complications.2,3 Because the platelets are produced from your own blood, there is no risk of rejection or disease transmission. As with any injection into the body, there is a small risk of infection, however it is very rare.

WHEN WILL I START TO FEEL RESULTS?
In two different studies evaluating the use of PRP for the treatment of epicondylitis (tennis elbow) both showed a gradual improvement at one month, three months and six months. These studies along with other studies treating different conditions suggest a reduction in pain and improvement in function. However, the results may vary depending on the patient and the severity of the condition. If you do not feel any improvement at your follow-up visit, additional injections may be necessary. It is important to exercise with restraint and to have routine follow-up examinations with your doctor before resuming normal physical activities. Discuss all your options with your treating physician to determine whether PRP is right for you.

WHO IS PROVIDING PRP THERAPY IN THIS COMMUNITY

PRP therapy is provided by David Goltra MD at Charleston Imaging in Mt. Pleasant South Carolina.  Dr Goltra is a Radiologist with extensive interventional radiologic training and experience.  In this community only Dr Goltra is utilizing ultrasound guidance for PRP injections.  Ultrasound is a completely safe and very powerful imaging modality which allows Dr Goltra to visualize the area of injury or degeneration and actually visualize the PRP as it is injected into the affected area

1. Peerbooms JC, Sluimer J, et al. Am J of Sports Med. 2010; 38:225.
2. Hecthman K, Uribe J, et al. Orthopedics. 2011; 34:2
3. De Vos RJ, Weir A, et al. JAMA. 2010; 303(2):144-149.
4. Barrett S, Erredge S, Podiatry Today. 2004; 17:36-42.
5. Kon E, Filardo G, et al. Injury. 2009; 598-603.

East Cooper Medical Center recently announced that Charleston Imaging has become a division of the hospital’s growing system.　The deal was finalized Wednesday, Jan. 19.

Founded in 2006 by David Goltra, MD, Charleston Imaging is an outpatient diagnostic and interventional radiology center accredited by the American College of Radiology. Charleston Imaging has developed a reputation of providing superior clinical images, as well as excellence in interventional procedures, and will continue to offer patients the same high-quality, compassionate care.

Located near the I-526 and Long Point Road intersection at 582 Lone Tree Drive in Mt. Pleasant, Charleston Imaging will continue to operate under the same name, but shall be identified as a division of East Cooper Medical Center.

“We are extremely proud of the unique nature of Charleston Imaging,” said Dr. Goltra. “We can image, diagnose and treat patients in one office, and typically in a short amount of time. The partnership (with ECMC) will allow us to offer patients even more diagnostic services and an expansion of care.”

“Charleston Imaging’s focus will remain the same–to offer comprehensive radiology services by highly trained specialists. Now, Charleston Imaging’s patients will benefit from the easily accessible continuum-of-care provided at East Cooper Medical Center–care that patients travel the globe to receive,” said Janie Sinacore-Jaberg, chief executive officer of East Cooper Medical Center.

“We’re delighted Charleston Imaging will be joining the East Cooper family. Their excellent reputation speaks volumes about the quality of care they provide, and their mission fits perfectly with ours–to provide high quality healthcare services to the Lowcountry.”

ABOUT EAST COOPER MEDICAL CENTER

East Cooper Medical Center, part of Tenet South Carolina, is a 130-bed acute care hospital located at 2000 Hospital Drive in Mount Pleasant.　Previously located at 1200 Johnnie Dodds Blvd., East Cooper Medical Center has been providing healthcare to the East Cooper community since 1986. We provide a number of services, including 24-hour emergency care, women’s and children’s services, diagnostic imaging and interventional services, orthopedics, sports medicine, pain care, adult and pediatric rehabilitation services, wound care services and surgical care, including nationally recognized spine surgery and breast reconstruction surgery. East Cooper Medical Center is accredited by The Joint Commission, the nation’s oldest and largest hospital accreditation agency.

ABOUT CHARLESTON IMAGING

Charleston Imaging provides cutting-edge imaging technology managed by board-certified fellowship-trained radiologists, and is capable of generating images that are unsurpassed in resolution and clinical detail. Charleston Imaging was formed by local physicians in 2006 with the goal of providing South Carolinians with convenient, state-of-the-art diagnostic imaging at an economical price. Our center provides a comfortable and relaxing environment along with compassionate, highly experienced technologists to deliver the best experience possible. Services Offered: MRI, CT, Digital X-ray, Ultrasound, Image Guided Procedures.

How to prepare for the exam

You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing if it is loose-fitting and has no metal fasteners.

Guidelines about eating and drinking before an MRI exam vary with the specific exam. For some types of exams, you will be asked to fast for 8-12 hours. Unless you are told otherwise, you may follow your regular daily routine and take medications as usual. Some MRI examinations may require the patient to swallow contrast material or receive an injection of contrast into the bloodstream. The radiologist or technologist may ask if you have allergies of any kind, such as allergy to iodine or x-ray contrast material, drugs, food, the environment, or asthma. However, the contrast material used for an MRI exam, called gadolinium, does not contain iodine and is less likely to cause side effects or an allergic reaction.

The radiologist should also know if you have any serious health problems or if you have recently had surgery. Some conditions, such as severe kidney disease may prevent you from being given contrast material for an MRI. Women should always inform their physician or technologist if there is any possibility that they are pregnant. If you have claustrophobia (fear of enclosed spaces) or anxiety, you may want to ask your physician for a prescription for a mild sedative.

Jewelry and other accessories should be left at home if possible, or removed prior to the MRI scan. Because they can interfere with the magnetic field of the MRI unit, metal and electronic objects are not allowed in the exam room. These items include:

• jewelry, watches, credit cards and hearing aids, all of which can be damaged.
• pins, hairpins, metal zippers and similar metallic items, which can distort MRI images.
• removable dental work.
• pens, pocketknives and eyeglasses.
• body piercings.

In most cases, an MRI exam is safe for patients with metal implants, except for a few types. People with the following implants cannot be scanned and should not enter the MRI scanning area unless explicitly instructed to do so by a radiologist or technologist who is aware of the presence of any of the following:

• internal (implanted) defibrillator or pacemaker
• cochlear (ear) implant
• some types of clips used on brain aneurysms

You should tell the technologist if you have medical or electronic devices in your body, because they may interfere with the exam or potentially pose a risk, depending on their nature and the strength of the MRI magnet. Examples include but are not limited to:

• artificial heart valves
• implanted drug infusion ports
• implanted electronic device, including a cardiac pacemaker
• artificial limbs or metallic joint prostheses
• implanted nerve stimulators
• metal pins, screws, plates, stents or surgical staples

In general, metal objects used in orthopedic surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of another imaging procedure. If there is any question of their presence, an x-ray may be taken to detect the presence of and identify any metal objects. Patients who might have metal objects in certain parts of their bodies may also require an x-ray prior to an MRI. Dyes used in tattoos may contain iron and could heat up during MRI, but this is rarely a problem. Tooth fillings and braces usually are not affected by the magnetic field but they may distort images of the facial area or brain, so the radiologist should be aware of them.

After the exam

If you have not been sedated, no recovery period is necessary. You may resume your usual activities and normal diet immediately after the exam. A few patients experience side effects from the contrast material, including nausea and local pain. Very rarely, patients are allergic to the contrast material and experience hives, itchy eyes or other reactions. If you experience allergic symptoms, a radiologist or other physician will be available for immediate assistance.

It is recommended that nursing mothers not breastfeed for 36 to 48 hours after an MRI in which a contrast material was given.

M.R.I.’s Help Fight High Risk of Cancer

By DENISE GRADY

For women with a high risk of breast cancer because of genetic mutations or family history, yearly M.R.I. scans in addition to mammograms and breast exams may save lives, a new study finds.
The study, the first to measure survival in a large number of high-risk women receiving M.R.I.’s, found that after six years of follow-up, 93 percent of mutation carriers with cancer were still alive, compared with 74 percent alive at five years in earlier studies. In the new study, all of the women at high risk because of family history were still alive after six years.

Experts began several years ago to recommend yearly M.R.I. scans in addition to mammograms for high-risk women, because M.R.I. is better at finding tumors. Mammograms still detect some cancers that M.R.I.’s miss, so high-risk women are generally advised to have both tests. But until now, researchers did not know whether the combined testing saved lives.
“We have always assumed that if you find the cancer early, the patients will do better,” said Dr. Maxine Jochelson, director of imaging at the breast and imaging center at Memorial Sloan-Kettering Cancer Center in Manhattan (she was not involved in the study). “This is the first paper that really has taken a large number of women and shown that if you find disease earlier it does translate into some improved outcomes.”
The findings may offer a reprieve to some women with very high risk who thought that having their breasts removed preventively was the only way to avoid cancer and save their lives. More women may also become willing to be tested for mutations, since there could be a less drastic way to deal with them.

Read the full article here.

Charleston Imaging provides CT screenings, and you may call our office or your family doctor to schedule yours today.

Click the following link for an excellent article from the American Cancer Society:

Lung Cancer

CT Scans Can Reduce Cancer Deaths Study Shows

Laura Helock, RT

A graduate of Lancaster General, Laura moved to Charleston in April of 2010.  X-ray, CT, and Interventional Procedures will be her focus, and when she’s not hard at work, Laura enjoys the beach with her pets and fiance.

People can have osteoporosis without any signs or symptoms. When you have osteoporosis, your bones become weak and are more likely to break. Because it is a disease that can be prevented and treated, an early diagnosis can make a difference. At any age, it is never too late to take steps to protect your bones and prevent fractures (broken bones).

You can find out whether you have osteoporosis or if you should be concerned about your bones by getting a bone mineral density (BMD) test. A BMD test uses a special machine to measure bone density. Some people also call it a bone mass measurement test. This test lets you know the amount of bone mineral you have in a certain area of bone. Bone density testing can be done on different bones of your body, including your hip, spine, forearm (between the wrist and elbow), wrist, finger or heel. A BMD test is safe and painless, and it provides important information about your bone health. Your healthcare provider uses this information to make recommendations to help you protect your bones.

If you are diagnosed with osteoporosis, your healthcare provider may order laboratory and other tests. These tests can help your healthcare provider find out if you have another medical condition causing bone loss.

What A BMD Test Can Do

A BMD test is the only way to detect low bone density and diagnose osteoporosis. The lower a person’s bone mineral density, the greater the risk of having a fracture. A BMD test is used to:

• Detect low bone density before a person breaks a bone
• Predict a person’s chances of breaking a bone in the future
• Confirm a diagnosis of osteoporosis when a person has already broken a bone
• Determine whether a person’s bone density is increasing, decreasing or remaining stable (the same)
• Monitor a person’s response to treatment

Who Should Have a BMD Test?

There are some reasons (called risk factors) that increase your likelihood of developing osteoporosis. The more risk factors you have, the more likely you are to get osteoporosis and broken bones. Some examples are being small and thin, older age, being female, a diet low in calcium, lack of enough vitamin D, smoking and drinking too much alcohol.

Your healthcare provider may recommend a BMD test if you are:

• A postmenopausal woman under age 65 with one or more risk factors for osteoporosis
• A man age 50-70 with one or more risk factors for osteoporosis
• A woman age 65 or older, even without any risk factors
• A man age 70 or older, even without any risk factors
• A woman or man after age 50 who has broken a bone
• A woman going through menopause with certain risk factors
• A postmenopausal woman who has stopped taking estrogen therapy (ET) or hormone therapy (HT)

Some other reasons your healthcare provider may recommend a BMD test:

• Long-term use of certain medications including steroids (for example,   prednisone and cortisone), some anti-seizure medications, Depo-Provera®
  and aromatase inhibitors (for example, anastrozole, brand name Arimidex®)
• A man receiving certain treatments for prostate cancer
• A woman receiving certain treatments for breast cancer
• Overactive thyroid gland (hyperthyroidism) or taking high doses of thyroid hormone medication
• Overactive parathyroid gland (hyperparathyroidism)
• X-ray of the spine showing a fracture or bone loss
• Back pain with a possible fracture
• Significant loss of height
• Loss of sex hormones at an early age, including early menopause
• Having a disease or condition that can cause bone loss (such as rheumatoid arthritis or anorexia nervosa)

Types of Bone Density Tests

Central DXA: The National Osteoporosis Foundation (NOF) recommends a BMD test of the hip and spine by a central DXA machine to diagnose osteoporosis. DXA stands for dual energy x-ray absorptiometry. When testing can’t be done on the hip and spine, NOF suggests a central DXA test of the radius bone in the forearm. In some cases, the type of bone density testing equipment used depends on what is available in your community.

Healthcare providers measure BMD in the hip and spine for several reasons. First, people with osteoporosis have a greater chance of fracturing these bones. Second, these fractures can cause more serious problems, including longer recovery time, greater pain and even disability. BMD test results in the hip and spine can predict the likelihood of future fractures in other bones.

With most types of BMD tests, a person remains fully dressed, and the test usually takes less than 15 minutes. BMD tests are non-invasive, meaning that no needles or instruments are placed through the skin or body. When repeating a BMD test, it is best to use the same testing equipment and have it done at the same place. This provides a more accurate comparison with your last test result.

Although it is not always possible to have your BMD test at the same place, it is still important to compare your current BMD test to your last one.

Other Types of Tests:

In addition to central DXA, there are other methods to measure bone density that can predict the risk of breaking a bone. However, the results from these other methods are not equivalent to the results from a central DXA machine. Below are other BMD testing methods:

• pDXA (peripheral dual energy x-ray absorptiometry)
• QUS (quantitative ultrasound)
• QCT (quantitative computed tomography)
• pQCT (peripheral quantitative computed tomography)

The QUS method of BMD testing uses sound waves to measure bone density. The other types of equipment listed above use radiation. Except for QCT, the amount of radiation is very small. For comparison, you are exposed to 10–15 times more radiation flying in a plane round trip between New York and San Francisco.

Healthcare providers do not routinely use standard x-rays for BMD testing. While x-rays can identify broken bones, they are not sensi-tive enough to detect osteoporosis until 25 to 40 percent of bone density has been lost. By this time the disease is well advanced.

Screening Tests

Peripheral bone mineral density tests help identify people who are most likely to benefit from further BMD testing. This type of test is often done as a screening at health fairs and in some medical offices, but cannot be used to accurately diagnose osteoporosis. Peripheral BMD tests measure BMD in the extremities, including the forearm, wrist, finger or heel. This BMD testing method uses pDXA, QUS and pQCT.

People having a peripheral test should be aware that there are some limitations with this type of test. Comparisons between a peripheral test and a DXA test of the hip and/or spine may not be reliable. Peripheral tests are suitable for screening and
predicting the risk of fractures. Experts prefer the central DXA test for diagnosing osteoporosis and monitoring treatment in patients taking an osteoporosis medication.

If you have abnormal results from a peripheral BMD screening, you should follow up with your healthcare provider. Discuss whether you need additional testing, such as a central DXA test of the hip and/or spine.

Call Charleston Imaging today to set up your free screening!  (843) 352-0674

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information in article quoted from: http://www.nof.org

Our Lead MRI Tech, Francisco Tuttle, is featured on CNN!  View the link, and send us your feedback: info@chasimaging.com

http://www.cnn.com/video/?/video/us/2010/04/07/mattingly.bua.firehouse.subs.cnn

It’s an amazing story!

The Health & Wellness Expo is an excellent event for everyone to receive free healthcare information.  It will be held on Saturday, April 10, from 10:00 a.m. until 3:00 p.m. at the Citadel Mall in Charleston.  CNI will be present with four of our divisions: Charleston Imaging, Charleston Sleep, Neurology Consultants, and Retina Consultants.  We hope to see you there!!