What is Musculoskeletal Radiology?

Musculoskeletal Radiology is imaging of bony and muscular disease which may  result from injury (car accident, sports injury and work related injury), arthritis,  infection, cancer, or may be congenital (a disease you were born with).

How do we image the bones and muscles of the body? Where are services located?

There are many radiographic modalities which can be used to image the bones,  muscles, tendons (connect muscle to bone) and ligaments (connect bone to bone)  of the body.

These radiographic modalities include:

X-rays:   X-rays are performed at Bethesda North Hospital 
located at 10500 Montgomery Road in Cincinnati Ohio
and at Bethesda Arrow Springs in Lebanon, Ohio.  X-rays are taken 24 hours a day,  7 days a week.  The phone number is 745-1114. You will need a prescription from your doctor in order to have an x-ray taken.
 
Ultrasound:  Ultrasound is performed at the Bethesda North Hospital Radiology Department and also at the Bethesda North Hospital Medicenter located next to the main hospital.  This exam requires a prescription from your doctor and must be scheduled.  The central scheduling number is 569-6777.

Outpatient ultrasound examinations are scheduled from 8am to 3:40 pm Monday through Friday at Bethesda North Medicenter, 8:20am to 6:30pm Mon through Friday and 8:20am to 1:10pm on Saturdays at the main hospital and 1pm to 3:50pm Monday through Friday at Arrow Springs Medical Center

Nuclear Medicine Scan: Nuclear medicine scans are performed at the Bethesda North Hospital and also at Arrow Springs Bethesda North Outpatient facility.  These scans require a prescription from your doctor and must be scheduled.  The Central scheduling phone number is 569-6777.  Nuclear Imaging is performed Monday through Saturday at Bethesda North Hospital and Monday through Friday at Arrow  Springs. 

CT Scan (CT or computed tomography):  CT scans are performed at the Bethesda North Hospital and also at Arrow Springs Bethesda North Outpatient facility.  CT scans require a prescription from your doctor and must be scheduled.  The Central scheduling phone number is 569-6777.  Outpatient CT scans are performed  24 hrs a day/seven days a week at Bethesda North Hospital. Outpatient CT scans are performed at Arrow Springs from 7:00am to 7:30 pm Monday through Friday and 7:00am to 3:00pm Saturday and Sunday.

MRI (magnetic resonance imaging): Outpatient MRI scans are performed at Bethesda North Medicenter which is located adjacent to the main hospital.  An MRI scan requires a prescription from your  doctor and must be scheduled.  The Bethesda North Central  Scheduling phone number is 569-6777.

Outpatient MR imaging is performed at the Medicenter from 7am to 8pm Monday, Tuesday and Friday, 7am to 10:15pm Wednesday and Thursday ,and 7am to 2:15pm on Saturday.  Hours may vary if scan requires intravenous contrast or if an MR arthrogram is ordered.  Some MR scans may be performed in the Radiology Department at the main hospital.

What Imaging should I have?

The type of imaging that you will have is dependent on the type of injury or  disease process that you have and the location of this disease process in your  body.
  
Some types of injuries or diseases require just one type of imaging while others  are best evaluated with a certain combination of imaging modalities.

The imaging modality or modalities best suited to diagnose your suspected injury  or disease is determined by your physician, often in consultation with a  Radiologist

My doctor ordered an x-ray. What is it and what do I do?

X-rays are a form of electromagnetic radiation, similar to light; however, of  shorter wavelength.  They are invisible and are not felt.  X-rays can penetrate  solid objects such as the body producing a picture on film or a computer screen

 X-rays can be taken to evaluate the chest and abdomen; however, in  musculoskeletal imaging x-rays are taken to evaluate the bones and joints (where two or more bones come together).

My doctor ordered an Ultrasound. What is it and what do I do?

Ultrasound is the use of sound waves which can penetrate the body producing a picture of internal body structure.  The sound waves are invisible and are not felt.

Musculoskeletal ultrasound can be used to image a mass which may have been discovered by you or your doctor to determine its size, location and whether it is a cyst or a solid mass.  An ultrasound may also be ordered to assess for an abscess (a localized collection of pus) which may develop with a skin or muscular infection.

My doctor ordered a Nuclear Medicine Scan. What is it and what do I do?

A nuclear medicine scan requires an injection of a low dose radioactive material into the blood stream followed by imaging of the affected portion of the body on a nuclear medicine camera.
 
One of the most common test ordered for musculoskeletal imaging is a bone scan.  This may be limited to a small portion of the body such as the foot or may include the entire body.  The location is dependent on the injury or disease process that the scan was ordered to evaluate.  Bone scans may be ordered to evaluate bone pain, injury, neoplasm (mass) and infection.  Also may be ordered to evaluate a joint replacement for loosening. A bone scan will require delayed imaging up to 3-4hrs after the injection. 

Another common test frequently ordered for musculoskeletal imaging is a White Blood Cell scan which is used to evaluate an infectious process.

The nuclear medicine scan requires lying still for a short period of time while imaging is performed on the nuclear medicine gamma camera.

My doctor ordered a CT scan. What is it and what do I do?

A CT scan is an imaging modality that uses x-rays to obtain a cross sectional image (or slice) of the body.  A  CT scan produces an image with  much greater detail of bones, muscles and other body structures than an x-ray; however, requires a larger amount of radiation to do this.

A CT scan may be ordered to evaluate for a subtle fracture not seen on a regular x-ray or may be ordered to evaluate a complex fracture at a joint for pre-surgical planning.  Cat-scans can also be ordered to evaluate bone and muscular masses  and infection.

The CT scan sometimes requires the injection of dye into the vein prior to imaging to enhance the disease process.  A short period of fasting is usually required if the scan is performed with contrast.

My doctor ordered an MRI. What is it and what do I do?

An MRI uses a magnetic field which penetrates the body to form cross sectional  images of the body part being imaged.  MRI is used to image bone and muscle disease especially at joints i.e. shoulder, elbow, wrist, hip, knee and ankle joints.  MRI is very sensitive for evaluation of the bone marrow to evaluate for stress  fractures, osteomyelitis (infection of the bone) and bone masses.  MRI is also used to image muscle disease including injury (muscle tear and strain), infection  and masses. 

An MRI scan requires lying still for approximately 45minutes in an MRI scanner  which is a tubular structure.  Patients who suffer from claustrophobia may need oral sedation from their doctor before the scan. Some of the MRI scans require  intravenous contrast to enhance the images.  A short period of fasting may be  required if intravenous contrast is given. 

Your doctor may order an MR arthrogram.  This MR scan requires the injection  of dye into the imaged joint prior to the MR scan.  The joint injection is performed in the Radiology Department under x-ray (fluoroscopic) guidance.