Diagnostic Testing

A thorough history and physical examination is an important first step when evaluating a patient's health. This gives the provider essential information that allows them make the best possible decisions regarding treatment options or the need for further diagnostic testing. Often, treatment can begin without having completed any diagnostic studies, however, there are times when this is very helpful, and can give the provider more information to allow the following:

1) Rule out a disease or condition (cancer, tumor, infection) which would require immediate medical attention or co-treatment with another medical provider.

2) Provide an accurate diagnosis, so that all treatment options can be reviewed.

3) Identify contributing and/or complicating factors that may negatively affect recovery or health.

4) Support care for third party payors (ie. auto, work or general insurance)

With the above in mind, the providers at Falling Waters Injury & Health Management Center, have developed a number of diagnostic resources that allow us to provide the best possible care for each and every patient.


An x-ray or radiograph, is a noninvasive medical test that helps providers diagnose and treat a variety of conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce images of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.


X-rays are not always needed or required to provide care. They can, however, provide valuable information that can rule out or confirm certain conditions. They help to evaluate for fractures, dislocations, infections, arthritis, metabolic conditions or cancer.

Most bone x-rays require no special preparation. We most commonly refer our patients to have their x-rays performed at either Central Oregon Radiology Associated (CORA) or other professional facilities that have digital x-rays due to their superior quality, ease of evaluation, and immediate access on our computers. We also have Medical Radiologists (physicians specifically trained to supervise and interpret radiology examinations) analyze the images and send a signed report to the providers at Falling Waters Injury & Health Management Center, who review with you on a large monitor and discuss the results.

MRI & CT Scans


Magnetic Resonance Imaging or MRI, is a noninvasive medical test that helps healthcare providers diagnose and treat a number of medical conditions. MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. The images can then be examined on a computer monitor and printed or copied to CD. MRI does not use ionizing radiation like x-rays or CT.

Computed Tomography, also called a CT or CAT scan, is similar to an X-ray, requiring larger amounts of ionizing radiation to produce more detailed images of bones and other body structures. Images are taken in 360 degrees, then reconstructed via computer to give more detailed images than an X-ray. This is less effective than MRI, however, at evaluating the soft tissues.

Detailed MR images allow physicians to better evaluate various parts of the body and certain diseases that may not be assessed adequately with other imaging methods such as x-ray, ultrasound or computed tomography (also called CT or CAT scan). We refer to several local MRI Centers. We have complete confidence with the facilities we use because of their professional attitude toward our patients as well as their timely reports which are usually received within 24 hours.

Bone Scan

A bone scan, also known as a SPECT (Single-Photon Emission Computed Tomography) scan, is a test that identifies areas of bone turnover, be it due to growth or breakdown. This is used to evaluate damage to the bones, detect cancer that has spread (metastasized) to the bones, and monitor conditions that can affect the bones (including infection and trauma).


To complete a bone scan, a small amount of radioactive substance (radionuclide) is injected into the bloodstream. This substance has an affinity for areas where the bone is abnormal. A special CT scan is then performed, identifying areas where the radioactive substance has collected. These areas of abnormal bone show up as "hot spots" actually colored orange on the picture. A bone scan can often detect a problem up to weeks or months earlier than a regular X-ray.

Neuro-Diagnostic Testing

Neuro-Diagnostic testing is done to evaluate for possible nerve damage, and to help identify the cause so that appropriate treatment can be provided. Two of the most common neuro-diagnostic tests performed are Electromyogram (EMG) and Nerve Conduction Velocity (NCV) studies.

An Electromyogram (EMG) measures the electrical activity of the muscles at rest and while contracting. Nerve Conduction Velocity (NCV) studies measure how well and how quickly the nerves can send electrical signals. Nerves use these electrical signals (impulses) to control the muscles in the body, causing them to react in specific ways. Nerve and muscle disorders cause the muscles to react abnormally.

Measuring the electrical activity in muscles and nerves can help find diseases that damage muscle tissue (such as muscular dystrophy) or nerves (such as amyotrophic lateral sclerosis or peripheral neuropathies). EMG and nerve conduction studies are often done together to give more comprehensive neuro-diagnostic information.

Lab Testing

Diagnostic Lab Testing can provide valuable information to help rule a condition in or out, to formulate an accurate diagnosis and provide adequate treatment. After a thorough evaluation, the Physicians at Falling Waters will discuss the need to order lab tests as it relates to your individual case.

We use local labs at St. Charles Medical Center for routine medical testing as well as some of the most reputable advanced diagnostic testing facilities in the United States for specialized testing. All of the labs we use are government inspected and approved to meet clincal standards.


Blood tests are often grouped together in panels. These panels may be general in nature to help assess the overall state of your health, or they may be targeted to check for a specific disease or organ function. Although these panels include several tests, the analysis most often can be performed using a small sample of blood. Here are some examples of different groupings:

Chem-Screen Panel

The Chem-Screen Panel can screen for a wide variety of disorders. It contains tests useful in detecting bone, liver and kidney diseases. It may also assist in the diagnosis of diabetes, iron disorders and gout, and in assessing your risk for heart disease. When used for screening purposes, it provides the best value, as it reports a significant amount of information regarding your health to your physician. Chem-Screen Panels are often used as a tool by your doctor to establish your baseline (normal) and to monitor changes over time.

Comprehensive Metabolic Panel

This group of tests combines most (but not all) of the tests included in the Basic Metabolic and Hepatic Panels. Bone health is also checked by evaluating calcium, phosphate and alkaline phosphatase.

Electrolyte Panel

Maintaining water and salt balance is critical to life and good health. The electrolyte panel contains tests which are important indicators of the amount of water and salt in your body. Tests included are sodium, potassium, chloride and carbon dioxide. Some of the disorders that lead to imbalances of the electrolytes include dehydration from vomiting or diarrhea, and kidney disease. Certain drugs, especially diuretics used in treatment of heart disease, may also affect your electrolytes.

Basic Metabolic Panel

This group of tests extends the electrolyte panel to include measures of kidney function and glucose metabolism, associated with diabetes. The additional tests are creatinine, glucose and BUN.

Hepatic Function Panel

This panel focuses on liver function. Conditions such as hepatitis (an inflammation of the liver) may be diagnosed and monitored. Gallstones may also be detected. These tests may be used to check for liver disease while you are being treated with certain drugs.

Liver Function Tests

These tests indicate normal or abnormal condition of the liver, a vital organ with many functions including the removal of toxic substances from your blood. Liver function tests include albumin, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase, direct and total bilirubin, gamma glutamyltransferase (GGT), globulin, and lactate dehydrogenase (LD).

Bone Tests

These tests check for healthy bones as well as bone diseases. Tests for alkaline phosphatase, calcium, magnesium and phosphorous are some examples of bone tests.

Iron Balance Tests

The proper amount of iron in your body is required for good health. These tests include iron and total iron binding capacity, transferrin saturation, and ferritin. Iron tests screen for iron deficiency that can lead to anemia, or for iron overload (hemochromatosis), a potentially serious genetic disease.

Kidney Function Tests

These tests indicate normal or abnormal function of the kidney, the organ which filters your blood, preserving useful elements while discarding unwanted waste into the urine.

Kidney function tests include albumin, creatinine, total protein and blood urea nitrogen.



Genova Diagnostics

Metametrix Clinical Laboratory

Gastrointestinal Assessments

Assessments of gastrointestinal function include the renowned Comprehensive Digestive Stool Analysis and several other tests and panels yielding important information about the ecology of the GI tract, including intestinal wall integrity, small bowel bacterial overgrowth, yeast presence, immune function, parasite activity, specific intolerances, Helicobacter infection, and vaginal health.

Immunology Assessments

Assessments of immune function include the revolutionary Comprehensive Antibody Assessment, with its unique reporting of IgG antibodies for delayed reactions as well as IgE for immediate reactions to foods and other allergens.

Nutritional Assessments

Nutritional assessments range from Elemental Analysis (toxic and nutritional element levels), Amino Acids Analysis (of 40+ amino acids critical to healthy metabolism and detoxification), and Essential & Metabolic Fatty Acids Analysis (addressing the most widespread nutritional deficit in modern life).

Endocrinology Assessments

Assessments of endocrine function evaluate the body’s ability to regulate itself through hormone action. Tests include evaluations of sex and regulatory hormones (including human growth hormone mediator IGF-1), the Bone Resorption Assessment, and a Glucose/Insulin Tolerance Test.

Metabolic Assessments

Metabolic assessments measure the body’s detoxification processes, oxidative stress and antioxidant defense capabilities, cell energy, and cardiovascular health (with a comprehensive array of independent markers).