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Musculoskeletal imaging involves examination of bones, joints, and soft tissues using x-rays, ultrasound, computed tomography (CAT scan), arthrography, nuclear medicine (bone scan), and magnetic resonance imaging (MRI). Common indications for imaging examinations include, but not limited to, trauma/accidents, pain, infection and malignancy. Each examination is tailored to meet the specific needs or questions needing to be addressed; and a detailed history of past occurrences is important.
MRI of the Musculoskeletal System
Magnetic resonance imaging (MRI) uses radio waves and a strong magnetic field instead of x-rays to provide clear and detailed pictures of internal organs and tissues. Although MRI has been used to study almost every joint in the body, including the spine, hips, wrists and hands, it is most frequently used to image the knee and shoulder of the musculoskeletal system. MRI requires specialized equipment and expertise and allows evaluation of some body structures that may not be visible with other imaging methods. MRI is usually the best choice for examination of the body’s major joints because it gives such clear pictures of soft tissue structures near and around bones. It is widely used to diagnose sports-related injuries and work-related disorders caused by repeated strain, vibration, or forceful impact.
With MRI, physicians can locate and identify the cause of pain, swelling, or bleeding in the tissues in and around the joints and bones. The images allow the physician to clearly see even very small tears and injuries to tendons, ligaments and muscles, and even some fractures that cannot be seen on x-rays.
MRI is also useful for the diagnosis and characterization of infections such as osteomyelitis and tumors involving bones and joints.
Finally, MRI images can give physicians a clear picture of degenerative disorders such as arthritis, deterioration of joint surfaces, or a herniated disc. It is often used by neurosurgeons to evaluate the spinal cord after trauma.
Ultrasound of the Musculoskeletal System
Ultrasound involves the sending of sound waves through the body, which are then reflected off internal organs. The reflections are interpreted by special instruments that subsequently create an image of anatomic parts. Radiation is not used in ultrasound imaging procedures.
Ultrasound is a useful way of examining the body to detect problems with muscles, tendons, joints and soft tissue. Images are captured in real time, so they can often exhibit movement, function, and anatomy, as well as enable radiologists to diagnose a variety of conditions and assess damage after an injury or illness.
Ultrasound images are useful in diagnosing tendon tears and abnormalities of the muscles such as tears and soft-tissue masses. Bleeding or other collections of fluid in the muscles and joints can also be detected.