United Brachial Plexus Network, Inc.

A regular MRI shows everything. BPI kids don't sublux because of gravity but because of muscle imbalances and joint malformation. "Stand-up" and "open" MRIs don't have as good a resolution as standard MRIs, which might not matter if all you are looking for is gross changes is cartilage and bone. They are completely not acceptable if you are looking for avulsions or to visualize nerve pathways or damage.

MRI scans are much better for visualizing the joints of young kids, as CT scans - like x-rays - don't image soft tissue - ligaments/tendons/joint cartilage. CT-myelograms are different. These are used to look for avulsions. A radiopaque dye is injected into the spinal column and it mixes with the spinal fluid. Avulsions can be seen as "leaks" of this spinal fluid out through the avulsed nerves.

Kate

So a regular MRI wouldn't cause the joint to assume the correct position if my child is dislocated or subluxed because she would be laying down? I was thinking that gravity while laying down might make the joint look like it is in, or go into the correct position so I wasn't sure if it would be an accurate test. Because it seems like when I lay down my shoulder does assume a natural position and I don't have anything wrong with my shoulder. If my child has an injury and lays down for a test, will it make her shoulder look more normal that it really is? I was worried that if I didn't get the stand up MRI that it wouldn't be a true picture of what is or could be going on with her. Is that true? Also, does a 6 year old usually need to be under medication for the test to be done?

I dont understand much about it...yet.

I do know that my 3 mo old will be under sedation for the MRI. I think that is standard for an infant. If I remember correctly I was told that they have to be a certain age to the the CT type of scan.

A BPI shoulder dislocates or subluxes posteriorily - out the back. So if anything, lying down would exaggerate the subluxation IF it were somehow a "floating" type of subluxation/dislocation. But these dislocations/subluxations are locked in due to a malformed shoulder joint - the joint cannot be "reduced" (the ball popped back into place which is how shoulder dislocation is usually treated) because growth has caused the joint itself to conform to the new position of the shoulder joint.

The only proof that has been published about the stand-up MRI for BPI kids is that it is "as good as" regular MRI for diagnosing shoulder subluxation. No one has dared claim that it is superior in the literature, because that simply is not the case. If you were talking about inferior subluxation in adults, like stroke victims get, then yes, maybe sitting up would be better. But that would be only for mature shoulders subluxing under the force of gravity, not muscular imbalance. The MRI for BPI shoulders is to image how the joint itself has developed- which doesn't change whether you are lying down or sitting up.

Kate

email me mshatraw@aol.com i have been here and have seen some of the best docs in the bpi world, and i have some advise that i would love to share in private. i will also share our story. good luck and hope to hear from you.

Hi Carol,
I'm so sorry about your baby. I noticed however, that you are located in Florida. My son who is now 2 was born at Florida Hospital in Orlando and he was injured there. He has a Global Injury and Horner's Syndrome. We went to see Dr. Grossman in Miami. He is really fantastic. Nick had primary surgery at 4 months old and he started out with NOTHING. He now has feeling to his fingertips some bicep, tricep, and deltoid, it's more than I ever thought he'd get. I just thought I'd let you know about Dr. Grossman and how pleased I am with the results Nick has had with him.
Jo(mom to Nick LOBPI)