Imaging in Orthopaedics

Imaging in Orthopaedics can be invasive or non-invasive.

Imaging is important in assessing the extent of injury / injuries. Orthopaedic Surgeons need to have clear definition of the damage to either bone or soft tissue or both as a guide to prescribing relevant treatment.

INVASIVE

Arthrography

Arthrography is an invasive imaging technique thats allows the internal anatomy of the joint to be visualised. It involves injecting iodinated contrast material (single or double contrast material) into the joint, followed by radiological examination which is either Computer Tomography (CT) or Magnetic Resonance Imaging (MRI). It can be used for examining virtually any synovial joint, but it is mainly used for the shoulder, hip and knee.

Indications

• Know the extent of intra-articular injuries
• Confirm loosening of a prosthesis
• Confirm capsular tears
• Used in diagnose spinal pathology.

MRI Arthrography

Advantages

• Can improve the accuracy of examining joints
• Increased accuracy in interpretation of any pathology. 

Disadvantages

• Invasive procedure
• Expensive
• Small exposure to radiation.

CT Arthrography

Advantages

• Can improve the accuracy of examining joints
• Increased accuracy in interpretation of any pathology. 
• Examination is fast

Disadvantages

• Expensive
• Exposure to radiation.

CT Guided Bone Biopsy

This procedure is often conducted when a sample of tissue is needed for histological diagnosis. The tissue is obtained with from the bone itself or from the surrounding soft tissue. Under CT guidance, multiple special needles are introduced to obatin samples of tissue.

Indications

• A tissue is needed for histological diagnosis.

Advantages

• Can reduce the need for open excisional biopsies

Disadvantages

• Invasive procedure
• Small exposure to ionizing radiation.

Arthroscopy

Arthroscopy is a useful surgical and diagnostic tool for the orthopaedic surgeon. It is the technique of looking around the joint with an instrument called an arthroscope, to which a small camera is attached. The images are subsequently relayed back to a video monitor, allowing the surgeon and his team to view them.