Does the hardware used in surgery (orthopedic, plastic, neurosurgical, etc.) set off the metal detectors used in airport security or affect MRI scans? — Craig Lippit, PA-C, Cooperstown, N.Y.

All heavy metals, including titanium and aluminum, will cause distortion of the waves used in scanning, including MRI and metal detectors. The degree of distortion depends on the size of the metal piece. Researchers are working to develop MRI scanners that perform using thinner sections and/or increased frequency gradient strength. Specialized fast-scan sequencing may also cut down on distortions. — Claire Babcock O’Connell, MPH, PA-C (184-3)

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These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical question, submit it here.