A patient consultation and pre-scan safety screening at a diagnostic imaging centre: an MRI technologist guides Mr Li through clinical history, claustrophobia and noise precautions, ferromagnetic safety screening, and image reporting procedures before an MRI of his repeatedly dislocating right knee.
- Sarah · turn 1
Good morning, Mr Li. My name is Sarah, and I’m the MRI technologist looking after you today. I can see that your GP has referred you for an MRI of your right knee following a dislocation. Before we start, I’d like to ask you a few questions about the injury and go through some safety checks with you.
早安，李先生。我叫莎拉（Sarah），我是今天負責為您進行檢查的核磁共振放射技師。我看到您的全科家庭醫生因您右膝脫臼而轉介您來做核磁共振檢查。在開始之前，我想向您詢問幾個關於受傷情況的問題，並與您一起進行一些安全核查。
- Mr Li · turn 2
好的。其實我的右膝蓋已經不是第一次脫臼了。這次是因為前一陣子搬家，我蹲在地上整理東西蹲了很長時間。後來我站起來的時候，膝蓋突然一陣劇痛，感覺關節好像一下子錯位了，我當時連腿都不敢動。
All right. Actually, this isn't the first time my right knee has dislocated. This time it was because I moved house a while ago, and I was squatting on the floor organising things for a long time. When I stood up afterwards, there was a sudden sharp pain in my knee and it felt like the joint had slipped out of place. I didn't even dare move my leg.
- Sarah · turn 3
I see. So you were squatting for quite a while, and the pain started suddenly when you stood up. Did you fall or hit your knee against anything at the time? Also, when you say it was dislocated, was that confirmed by a doctor or with an X-ray?
我明白了。也就是說您蹲了相當長一段時間，站起來時突然開始劇痛。您當時有沒有摔倒，或者膝蓋有沒有撞到任何東西？另外，您說脫臼了，當時是否有經過醫生確診或拍攝X光確認？
- Mr Li · turn 4
沒有，我沒有摔倒，也沒有撞到任何東西。這次沒有去醫院照X光，因為以前也發生過幾次類似的情況，所以我大概知道是怎麼回事。我有一個朋友是做中醫推拿的，以前每次脫臼，我都會找他幫忙。
No, I didn't fall, and I didn't bump into anything. I didn't go to the hospital for an X-ray this time, because similar things have happened several times before, so I roughly knew what was going on. I have a friend who does Chinese massage therapy, and every time it dislocated in the past, I'd ask him for help.
- Sarah · turn 5
What did your friend do when this happened? I’m asking because it’s useful for us to know whether the joint went back into position by itself or whether someone had to manipulate it. And approximately how many times has this happened before?
發生這種情況時，您的朋友做了甚麼？我之所以詢問，是因為我們需要了解關節是自行復位還是有人進行了手法復位。另外，這種情況以前大約發生過幾次？
- Mr Li · turn 6
大概有三、四次了。每次都是他先幫我按摩膝蓋周圍的肌肉，讓肌肉慢慢放鬆下來，然後再用手把關節推回原來的位置。復位以後疼痛通常會減輕很多，所以以前我也沒有太在意。
About three or four times. Each time, he would first massage the muscles around my knee to help them relax, and then manually push the joint back into its original position. After it was put back, the pain would usually subside a lot, so I didn't pay much attention to it in the past.
- Sarah · turn 7
Right. That’s what we would describe as a manual reduction. Even if the joint can be put back into position, recurrent dislocations can sometimes damage the ligaments, cartilage or other soft tissues around the knee. That’s probably why your GP wants an MRI this time.
明白了。這就是我們所說的手法復位。即使關節能夠推回原位，反覆脫臼有時也會損傷膝關節周圍的韌帶、軟骨或其他軟組織。這可能就是您的全科醫生這次希望為您做核磁共振的原因。
- Mr Li · turn 8
對，家庭醫生也是這麼跟我說的。主要是最近膝蓋一直沒有完全恢復。平時走平路還好，但是一到陰雨天就會覺得酸酸痛痛的，而且現在上下樓梯也比較吃力。有時候我還會覺得膝蓋不太穩，好像隨時又會脫臼一樣。
Yes, that's what my GP said as well. It's mainly because my knee hasn't fully recovered recently. Walking on flat ground is fine, but whenever it's cloudy or raining, it aches, and going up and down stairs is quite a struggle now. Sometimes I even feel the knee is unstable, like it could dislocate again at any moment.
- Sarah · turn 9
That feeling of instability is important to investigate, particularly given the history of repeated dislocations. The MRI gives us detailed images of both the bones and the surrounding soft tissues, including the ligaments, tendons, cartilage and muscles. It can help your doctor determine whether there has been any structural damage.
這種關節不穩定的感覺非常值得深入檢查，特別是考慮到您有反覆脫臼的病史。核磁共振能為我們提供骨骼及其周圍軟組織的詳細影像，包括韌帶、肌腱、軟骨和肌肉。這能幫助您的醫生判斷是否存在結構性損傷。
- Mr Li · turn 10
明白了。我之前只照過普通的X光，沒有做過核磁共振。那這個檢查會痛嗎？是不是要打針或者注射甚麼藥？我聽別人說做核磁共振的時候，人要躺在一個很窄的機器裡面。
Understood. I've only had ordinary X-rays before, never an MRI. Does this scan hurt? Do you need to give me an injection or any medicine? I heard from others that when doing an MRI, you have to lie inside a very narrow machine.
- Sarah · turn 11
For this particular knee scan, we don’t expect to give you an injection or contrast dye. The examination itself is painless. You’ll lie on the scanning table with your right knee positioned inside a special coil, and the table will move into the scanner. The scan should take approximately ten to fifteen minutes.
對於這次的膝關節掃描，我們預計不需要為您注射藥物或顯影劑。檢查本身是無痛的。您會躺在檢查床上，右膝會放置在一個專用的線圈裝置內，然後檢查床會滑入掃描儀中。整個掃描大約需要十到十五分鐘。
- Mr Li · turn 12
那還好，十幾分鐘應該沒問題。我就是有一點擔心，因為我不太喜歡待在很狹窄的空間裡。不過如果只是膝蓋需要放進機器，而且時間不太長的話，我應該可以忍受。
That's not too bad; ten-odd minutes should be fine. I'm just a little worried because I don't really like being in confined spaces. But if only the knee needs to go into the machine and it doesn't take too long, I should be able to manage.
- Sarah · turn 13
That’s understandable. Because we’re scanning your knee, your positioning may be more comfortable than you expect. If you become uncomfortable or anxious at any stage, you’ll have an emergency call button in your hand. Press it and let us know. We’ll be able to hear you and communicate with you throughout the scan.
這很能理解。因為我們掃描的是您的膝蓋，所以您的姿勢可能會比想像中舒適得多。如果您在任何階段感到不適或焦慮，手裡會拿著一個緊急呼叫按鈕。按下去通知我們即可。在整個掃描過程中，我們都能聽到您的聲音並與您保持溝通。
- Mr Li · turn 14
好的，那我就放心多了。還有甚麼需要注意的嗎？我今天穿的牛仔褲上面有金屬拉鏈，而且身上還有手錶、手機和鑰匙。這些東西是不是都不能帶進去？
Great, that puts my mind at ease. Is there anything else I need to be aware of? The jeans I'm wearing today have a metal zipper, and I also have my watch, mobile phone and keys on me. Can none of these be taken inside?
- Sarah · turn 15
That’s correct. MRI scanners use a very powerful magnetic field, so you must remove metal objects before entering the scan room. Please leave your phone, keys, watch, wallet and any other personal belongings in the locker provided. We may also ask you to change into a gown if your clothing contains metal.
沒錯。核磁共振掃描儀使用非常強大的磁場，因此在進入檢查室前必須取下所有金屬物品。請將您的手機、鑰匙、手錶、錢包及其他個人物品存放在我們提供的儲物櫃中。如果您的衣服含有金屬，我們也可能需要請您換上檢查袍。
- Mr Li · turn 16
沒問題，我可以換衣服。我身體裡面沒有金屬，也沒有做過甚麼植入物手術。不過我以前補過牙，嘴裡有幾顆牙冠。這個應該不會影響檢查吧？
No problem, I can change clothes. I don't have any metal inside my body, nor have I had any implant surgery. But I had fillings done before, and I have a few dental crowns in my mouth. That shouldn't affect the scan, should it?
- Sarah · turn 17
Dental fillings and most standard dental work are generally fine, but thank you for mentioning them. As part of our safety screening, I also need to confirm that you don’t have a pacemaker, cochlear implant, surgical clips, metal fragments or any other implanted medical device in your body.
補牙和絕大多數常規牙科修復物通常都沒有問題，但還是感謝您主動提及。作為安全篩查的一部分，我還需要確認您體內沒有心臟起搏器、人工耳蝸、手術金屬夾、金屬碎片或任何其他植入式醫療裝置。
- Mr Li · turn 18
沒有，這些都沒有。我以前也沒有做過甚麼大手術，所以身體裡應該沒有任何金屬。我剛才填安全問卷的時候也把這些問題都看過了，全部都填的是「沒有」。
No, none of those. I've never had any major surgery before either, so there shouldn't be any metal in my body. When I filled out the safety questionnaire earlier, I went through all these questions and marked 'no' for all of them.
- Sarah · turn 19
Excellent. There’s one more thing I need to prepare you for. The scanner makes a series of very loud knocking, tapping and buzzing noises while it’s taking the images. That’s completely normal. We’ll give you earplugs to protect your hearing, so don’t be alarmed when the noise starts.
很好。還有一點我需要讓您做好心理準備。掃描儀在採集影像時會發出一系列非常大的敲擊聲、嗒嗒聲和嗡嗡聲。這完全是正常的。我們會為您提供耳塞來保護聽力，因此當噪音開始時，請不要驚慌。
- Mr Li · turn 20
原來是這樣。我還以為做核磁共振的時候機器應該很安靜呢。那我戴上耳塞就可以了。檢查的時候我可以稍微動一下腿嗎？我的膝蓋保持同一個姿勢太久，有時候會有點不舒服。
I see. I actually thought the machine would be quite silent during an MRI. So wearing earplugs will be fine. Can I move my leg slightly during the scan? If my knee stays in the same position for too long, it sometimes feels a bit uncomfortable.
- Sarah · turn 21
It’s very important that you remain as still as possible while each set of images is being taken. Even a small movement can blur the images, and we may have to repeat part of the scan. We’ll position your knee carefully and use some padding to make you more comfortable before we begin.
在拍攝每組影像時，請您務必盡可能保持完全靜止。即使是微小的晃動也會導致影像模糊，我們可能就不得不重複掃描某些部分。開始之前，我們會仔細調整您膝蓋的位置，並使用軟墊讓您感覺更舒適。
- Mr Li · turn 22
好的，那我會盡量保持不動。如果真的很痛或者實在忍不住，我就先按您剛才說的那個緊急按鈕，而不是自己突然坐起來或者移動腿，對嗎？
Okay, I'll do my best to remain still. If it really hurts or I really can't bear it, I should first press the emergency button you mentioned earlier, rather than suddenly sitting up or moving my leg myself, right?
- Sarah · turn 23
Exactly. If you experience significant pain, feel unwell, become anxious or simply need us to stop for any reason, press the button and we’ll respond straightaway. Don’t try to get off the table by yourself while the scan is in progress.
沒錯。如果您感到劇痛、身體不適、焦慮，或因任何原因需要我們暫停，只需按下按鈕，我們就會立即回應。在掃描進行期間，切勿自行嘗試從檢查床上爬起來。
- Mr Li · turn 24
明白了。那檢查做完以後，我今天就能知道膝蓋到底有沒有韌帶或者軟組織損傷嗎？還是我要回去找家庭醫生看報告？
Understood. After the scan is done, will I be able to find out today whether there's any ligament or soft tissue damage to my knee? Or do I need to go back and see my GP for the report?
- Sarah · turn 25
The images will need to be reviewed by a radiologist, who will prepare a formal report. We can’t give you a diagnosis here immediately after the scan. The report will be sent to the GP who referred you, and your GP can discuss the findings and any further treatment with you.
這些影像需要由放射科專科醫生仔細閱片並撰寫正式報告。我們無法在掃描結束後立即為您提供診斷。報告會發送給為您開具轉介信的全科家庭醫生，您的醫生會與您討論檢查結果以及後續的治療方案。
- Mr Li · turn 26
好的，那我做完以後再跟家庭醫生預約。我主要就是想弄清楚為甚麼這幾年一直反覆脫臼。如果真的有韌帶或者其他地方受傷，我也希望可以早點治療，不然現在連爬樓梯都有點困難。
All right, I'll make an appointment with my GP after it's done. I mainly want to find out why it has been repeatedly dislocating over the past few years. If there really is damage to the ligaments or other areas, I hope to receive treatment sooner, otherwise even climbing stairs is quite difficult right now.
- Sarah · turn 27
That makes sense. Your GP can decide on the next step once the MRI report is available, which might include physiotherapy or referral to a specialist, depending on what the scan shows. For now, we’ve completed all the safety checks. Please remove your metal items, change into the gown and I’ll help you get into position.
這很有道理。拿到核磁共振報告後，您的全科醫生會根據掃描結果決定下一步方案，這可能包括物理治療或轉介給骨科專科醫生。現在我們已經完成了所有安全檢查。請取下您的金屬物品並換上檢查袍，我會協助您就位。
- Mr Li · turn 28
好的，我都清楚了。我會把手機、手錶、鑰匙和其他金屬物品全部放在外面的儲物櫃裡。檢查的時候我會保持不動，有任何不舒服就按緊急按鈕。那我們現在開始吧。
Okay, everything is clear to me now. I'll put my phone, watch, keys and all other metal items in the locker outside. I will stay completely still during the examination, and if I feel uncomfortable at all, I'll press the emergency button. Let's get started now.
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