Before a treatment plan can be made, your orthopedic doctor must first determine the source of your musculoskeletal injury or condition. This typically involves a physical exam, a review of your medical history, and about 1,000 questions. For many patients, additional diagnostic testing is needed. Here are some of the tests most commonly used by orthopedists.
Magnetic resonance imaging is a test that uses radio waves to make detailed pictures of the inside of your body. It is more effective than an x-ray for seeing soft tissues such as ligaments, tendons, and muscle. An MRI scan usually takes about 30 minutes to an hour.
The same machine used for MRIs can also be used for MRAs (magnetic resonance angiography), which is used to get detailed images of blood vessels to assess certain orthopedic conditions.
X-rays are a quick way for your orthopedic doctor to view your bones for fractures, injuries, and joint abnormalities. Most traditional film-based x-ray machines have been replaced with digital systems, which offer enhanced image quality and less radiation.
If you suspect you will need an x-ray, look for an orthopedic clinic with an in-house x-ray machine and radiology techs on staff. You will likely be able to knock out the x-ray during your initial visit and have the results immediately. Otherwise you’re stuck making a separate appointment at a nearby hospital or imaging center with additional out-of-pocket cost, potentially.
An EMG is a test that measures the electrical activity of muscles and nerves to help detect abnormalities. This procedure uses small needles which are inserted through the skin into the muscle. While the sound of needles might make you feel uneasy, many people actually find the test to be painless. Some orthopedic clinics are able to perform this test in-house.
A joint aspiration allows orthopedists to analyze the synovial fluid contained in a joint, usually the knee. It is a relatively quick procedure using a needle and syringe to remove the fluid. This test is commonly used to determine which type of arthritis a patient may have, but it has several other diagnostic uses.
The procedure also has a therapeutic purpose. The removal of excess fluid may help relieve pain and swelling.
Computed tomography combines x-rays with computer technology to create a detailed, cross-sectional image of your body. It works by moving in a circle around the body to get different views. CT scans of bones can provide more detailed information about the bone tissue and bone structure than standard x-rays.
This test consists of a contrast dye injection directly into a joint, followed by an MRI or CT scan of the joint. An arthrogram provides a clear image of the soft tissue and helps pinpoint what’s wrong with your joint. An arthrogram is often used to help diagnose persistent, unexplained joint pain.
A myelogram is a procedure done to show if there are any spinal abnormalities by using a contrast dye injection into the spinal canal followed by a CT scan. This test can detect certain issues that a traditional CT scan or an MRI can miss. The dye will blend together with your spinal fluid, resulting in a clear look at the bones and soft tissues.
For the purposes of diagnosing bone conditions, there are three common types of bone scans: DEXA, whole-body, and three-phase.
To help detect weak or brittle bones, your orthopedic doctor may use a dual energy x-ray absorptiometry (DEXA) scan. It is the standard method for ediagnosing osteoporosis.
A whole-body bone scan is a nuclear imaging procedure using a special camera that takes images of your entire skeleton a few hours after the injection of a radioactive tracer. This test can help orthopedic doctors diagnose a wide range of bone conditions.
A three-phase bone scan is similar in technique to the whole-body scan, but the focus is on a specific part of the body and requires two sets of imaging: one at the same time as the tracer injection and the second set after a certain period of time.
A Doppler ultrasound is not used by orthopedic doctors to determine the source of a musculoskeletal injury or condition, but instead as a precautionary measure to screen for lower extremity deep venous thrombosis following a major fracture or surgical procedure such as a knee or hip replacement. DVT is a risk factor for certain people.