Magnetic Resonance Imaging (MRI)
MRI is one of the more commonly used modalities in musculoskeletal imaging. A variety of imaging MRI sequences can be used in the definition of normal anatomy and in the detection of abnormal fluid or enhancement. MRI is especially useful in the diagnosis and evaluation of conditions affecting soft tissues, such as tears to tendons and ligaments.
Compared with other modalities used in musculoskeletal imaging, MRI is costly. Relatively long exam times can also make MRI less patient-friendly in some instances. However, MRI does not expose patients to radiation. Diagnostic accuracy of MRI relies on expert interpretation.
Computed Tomography (CT)
CT is an exceptional option for producing detailed visualizations of anatomy and assessing bones. Exams can generally be performed in under one minute and are easily reproduced. Multi-slice CT enables multiplanar reconstruction for alternative views that aid diagnosis and evaluation of musculoskeletal conditions.
CT is moderately expensive when compared with other imaging modalities used in musculoskeletal radiology. Radiation dose associated with CT is significantly higher than with conventional radiography. CT can adequately produce visualizations of soft tissues, although not as clearly as MRI.
Recent technological advancements have led to a stronger role for ultrasound in musculoskeletal imaging. Ultrasound is capable of producing high resolution images of tendons, muscles and nerves. Real-time imaging is also possible with ultrasound and can be more patient friendly than MRI.
Ultrasound is a moderately priced exam compared with other musculoskeletal imaging modalities. Ultrasound can adequately visualize medial, lateral and patellar ligaments, although it is not effective at detecting meniscal or cruciate tears.
X-ray is widely available and generally the first type of imaging exam performed when a musculoskeletal condition is suspected. Standard views are produced during X-ray and are easily reproduced, although supplemental views can also taken. X-ray exams are generally quick and patient friendly. Fluoroscopy enables real-time imaging with X-ray.
X-ray is useful for diagnosing broken and fractured bones, as well as other musculoskeletal conditions, although it cannot effectively visualize soft tissues. Compared with other musculoskeletal imaging modalities, X-ray is inexpensive.
Interventional Radiology (IR)
Medical imaging enables certain interventional procedures to treat and diagnose musculoskeletal disorders. Image-guided interventions can often be used in place of more invasive treatments, like surgery. Interventional musculoskeletal radiology procedures include epidural steroid injections, nerve root block and joint injections.
MR arthrography is the preferred technique for examining joints. Prior to an MR arthrography procedure, a contrast dye is injected into the joint being examined. This allows the radiologist interpreting the exam to more clearly see soft tissues, like ligaments and cartilage. MR arthrography is commonly performed to evaluate instability in the shoulder, tears of the cartilage labrum in the hip and damage to ligaments in the wrist.