When is an X-ray used versus an MRI and ultrasound or a CT scan?

X-rays... Broken bones, intestinal obstructions, bladder stones, things like that. Those are what I think... Dentistry. Those are where I think that X-rays, they serve their purpose. They've been around forever, not forever, but I mean, they've been around a very long time, but they serve their purpose. They work very well for that, and they're much more cost-effective. So things like that. That's what I'm reaching for first.

If I need to look at a soft tissue structure and I need to see the internal components of said soft tissue structure, then I'm grabbing my ultrasound. It allows you to look at the internal components of the bladder, the kidneys, the liver. I can see the vasculature and the blood flow and the drainage in everything from the liver to the heart, and I can see the heart valves. I can actively see the heart contracting and watch the heart valves fluttering and closing with an ultrasound. So it's perfect for that kind of study.

MRIs and CT scans are more advanced. You need much more acute detail. We've all seen medical shows on TV. What does an MRI or CT scan look like? It's a hundred little slices. You see their films on the wall and it’s got all these tiny images, not tiny images, or small squares on these great big films. That machine will hypothetically take hundreds of slices as it goes through the tissues and it lays them down and puts them on a film.

Say you’ve got a brain tumor. You're looking at a soft tissue structure that's encased in bone. I can't see that on an X-ray. My X-ray is going to pick up that bone. It's going to be bright white, but I can't see the soft tissue of the brain underneath. Ultrasound cannot penetrate the bone. So that's useless to try to see that. You need something that can actually take those slices, if you will, of tissue, and then be able to look at them this way. You'll see the bone, but you'll also see all the soft tissue encased underneath. And you can literally say, "Okay, this is at one millimeter, two millimeters." It's probably smaller than that, but you can literally break it down and have a sequential step. So you can see exactly where a growth or a mass or any kind of a lesion starts and stops based on that.

Lastly, too, I know MRI is pretty superior when you're looking at ligament. Let’s say you have a torn cruciate or a torn meniscus and for whatever reason; my mind is stuck on knees right now. But if you have some sort of a soft tissue structure, an orthopedic soft tissue structure, MRI is really hard to beat if you need that kind of acuity to see if something is torn or partially torn. No other study can touch that kind of accuracy that you get with MRI on that.