The Haunting Terms of Imaging
Can we all agree how scary terms like degenerative disc disease (DDD) or stenosis are? They commonly get thrown out in the presence of Medical Doctors, Radiologists, and Chiropractors. For most this seems like a life sentence to some form of disability. It certainly can’t be unseen or forgotten and most people will hold onto this information indefinitely. In my experience the seeing of these terms has a lasting effect on someone’s perspective of their future health. Patient’s tend to expect to always have pain based on these radiologic terms and while this may be true in specific cases the opposite can also be said. Some patients will have DDD for the majority of their life and not even know it. In this blog I hope to unpack the scariness of common diagnoses seen on radiographic reports.
Not everyone is familiar with the proverbial ‘medicalese’ that medical professionals seem to speak without hesitation. This ‘medicalese’ is almost like a foreign language to the everyday person who is not involved with the medical world. This can be a source of anxiety right from the start. Berkman et. al. in their 2011 article made the comment stating, “Low health literacy is linked with negative health outcomes, increased use of hospital services and higher levels of mortality in older populations.” (1). Health literacy is one way of describing the aptitude of someone to understand their health and what is being said about it. I find it staggering a statement like that of Berkman et al. as it directly shows the connection between not knowing/understanding of health terms and your health.
There is a growing base of information on communication between a medical professional and the patient and it continues to say that our words matter. This is most evident when looking at radiographic reports as Onder et al. made this statement in their 2021 article, “the imaging report, as a form of stand-alone communication, is vulnerable to error and misinterpretation.” (2). The way something is communicated to a patient can be either positive or negative and I have found communicating face to face is an easier way to quell any misunderstandings or education gaps. In the olden days (just kidding it's not that long ago) it was commonplace for the patient to receive their imaging report before a medical professional could interpret. This usually leads to the patient utilizing the infamous ‘Dr. Google’, which can be somewhat bleak at times. ‘Dr. Google’, while at times is a great asset, can have detrimental effects on our mental state. It presents items in a matter of fact manner and like most things in life there is a gray area.
Can these scary terms mean pain and discomfort? The answer is yes and no. Pain is incredibly complex and multifactorial. It very rarely is caused by one specific cause unless it is related to a traumatic event. To support this claim I like to mention the 2015 article by Brinjikji which found that 37% of those at age 20 and 96% of those at age 80 had DDD and were ASYMPTOMATIC! (No symptoms). How crazy is that? These same researchers made this conclusion, “Many imaging-based degenerative features are likely part of normal aging and unassociated with pain.” (3). A huge statement to say the least. There is a disclaimer attached in saying this is not the case with everyone, but I would love to take a more hopeful stance on the issue.
With all this being said, can these terms be frightening? Yes! They absolutely can, but don’t always have to be. The majority can be chalked up to normal age related changes that could possibly give you issues, but they are not a permanent sentence to a life full of pain and discomfort. As always, I believe in you and hope you continue to kick butt.
Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., Viera, A., Crotty, K., Holland, A., Brasure, M., Lohr, K. N., Harden, E., Tant, E., Wallace, I., & Viswanathan, M. (2011). Health literacy interventions and outcomes: an updated systematic review. Evidence report/technology assessment, (199), 1–941.
Onder, O., Yarasir, Y., Azizova, A., Durhan, G., Onur, M. R., & Ariyurek, O. M. (2021). Errors, discrepancies and underlying bias in radiology with case examples: a pictorial review. Insights into imaging, 12(1), 51. https://doi.org/10.1186/s13244-021-00986-8
Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., Halabi, S., Turner, J. A., Avins, A. L., James, K., Wald, J. T., Kallmes, D. F., & Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American journal of neuroradiology, 36(4), 811–816. https://doi.org/10.3174/ajnr.A4173
