Stephen F. Conti, MD
Radiology uses imaging technology to help diagnosis and treat various conditions within the body. Patients with orthopaedic conditions are often asked to obtain images so physicians can better understand an injury or ailment. Knowing the benefits and limitations of radiology can be helpful to patients looking to take a more active role in their health.
The most basic type of test an orthopedic surgeon may use is an x-ray. X-rays are created by shining a small amount of radiation through a body part. The image is gathered on an x-ray film and processed. The advantages of x-rays are that they are easy to obtain and offer useful information about bones and joints. However, x-rays are a series of overlapping shadows, showing only two dimensions of a particular body part. Often times, three dimensions are necessary to get a complete understanding of a condition.
A Computed Tomography (CT) scan is very similar to an x-ray, but it provides the doctor with a 3D view of a part of the body, while CT scans give a very detailed picture of the anatomy of bones and joints they can often be time-consuming, and patients are subjected to more radiation than with an x-ray. Additionally, CT scans are not very good at assessing soft tissue structures like tendons and ligaments.
Magnetic Resonance Imaging (MRI) is often used to evaluate soft tissue. During an MRI, the patient sits or lies down in a machine that creates a magnetic field around the body. The magnetic field causes molecules in the body to vibrate, translating to detailed, 3D pictures that show inside the tendon or ligament. There is no radiation exposure to the patient.
Some patients may find sitting or lying in the machine to be claustrophobic. Also, if there is any metal in the body part being imaged, images may be blurry and unusable.
With a bone scan, a mildly radioactive material is injected into the vein and circulated throughout the body. By using a machine called a Geiger counter, the physician can track this material and detect any areas of inflammation throughout a bone or body part. While a bone scan can be useful in determining inflammation, it is a very nonspecific test, and focuses the physician's attention only on the body part being scanned.
Ultrasound is particularly helpful in evaluating tendons that sit just beneath the skin, such as the Achilles tendon. The advantage of an ultrasound is that it is a relatively simple test to perform. The disadvantage is that the image quality may not be as detailed as an MRI, and the clarity sometimes depends on the expertise of the person performing the test.
If your physician orders any type of imaging, consider having the test performed in the same hospital system as your doctor, if possible. This may allow the physician to review your test more conveniently, without requiring a return appointment to the office. At UPMC, all the radiology facilities are interconnected, which allows for easy and convenient online access from your physician.
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