Hello Docs,
I appreciate your feedback on whether I should move forward with an ordered CT exam. Is it really needed?
Context: Pelvis MRI in May 2026 that showed a subtle heterogeneous signal intensity identified within the rectus abdominis aponeurosis insertion at the pubic symphysis bilaterally with mild associated edema, concerning for subtle underlying moderate grade strain/partial tears. My surgeon says there may be possible athletic pubalgia??? Since I am still experiencing pain just below the belly button radiating down—it feels it is radiating down through my genitalia and my inguinal area and testicular area are sore to the touch and painful—my hernia surgeon says that the pelvis MRI does not show his umbilical region and he wants it evaluated. He has ordered a CT A/P with IV contrast for Periumbilical pain and groin pain.
Since I already had a pelvis MRI, would there be any benefit to moving to a CT given that the MRI has already shown mild edema and a possible moderate strain or tear in the rectus abdominus? Also, do I really want to subject myself to radiation and dye contrast (oral and IV)?
I apologize, as this is somewhat repetitive of a previous post, but a different question pertaining to the CT.
Thank you for your feedback! It is very much appreciated! Also, thank you for taking the time to provide this forum. Have a blessed day!
1 Like
Hey Paul,
Sorry to hear you are in pain. I’m also sorry to say, we cannot answer this question on the forum as we are not your physician.
Your physician may have mentioned what I’m about to tell you, but typically a pelvis MRI and CT A/P are ordered for different reasons (and regions). Whether that’s worth the contrast and radiation depends on how concerned he is and what your physician is concerned about based on their exam and your history.
So the person to answer “is this really needed” is back to your physician. That’s a completely fair question to ask them directly: what are you looking for, what changes based on the result, and is there a non-contrast or alternative option given my concerns about dye and radiation. A surgeon who ordered a reasonable test should be able to tell you exactly what they’re chasing. If his answer satisfies you, do it. If it doesn’t, that’s your opening to push or get another opinion.
Sorry I can’t be of more help.
-Jordan
1 Like
Thank you for your feedback. I will send my surgeon a message and find out why he has specifically ordered a CT scan. Out of curiosity, what is the difference between a pelvis MRI and CT A/P? Thanks again and have a blessed evening!
-Paul
2 Likes
As you likely know, MRIs and CTs go about their job of looking at the body in different ways.
An MRI uses magnetic fields, no radiation, and gives the best detail on soft tissue, e.g. muscle, tendon, etc. It was also a focused study, aimed just at the pelvis.
A CT A/P uses x-rays, so yes, there’s the radiation and the iodinated contrast. It also covers a much larger area, from the abdomen down through the pelvis, and it’s better for a broad survey: bowel, organs, vessels, fluid, and hernias. The IV contrast lights up vessels and organs, oral contrast outlines the bowel, which helps catch things like a hernia or another structural cause.
So the two aren’t really redundant, even though it feels that way after already having the MRI.
1 Like
Wow! Thank you for the thorough explanation! I appreciate it!
1 Like