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Missouri Orthopaedic Institute
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Radiology


Radiology Services at MOI

All images performed at MOI are interpreted by radiologists with advanced training in orthopaedic imaging. We provide expertise in plain X-rays, ultrasound, injections, CAT scan and MRI.

X-Rays

Plain X-rays are usually the first imaging study ordered to diagnose bone and joint abnormalities. X-rays use a very small and safe dose of radiation. They are excellent for detecting broken bones, abnormal joints and many tumors. For more information, please follow the link below:

X-Rays

Ultrasound

Ultrasound uses sound waves to make a diagnosis. It does not use radiation. Ultrasound cannot see through bone, but it is very good to evaluate soft tissues. It can evaluate tendons, ligaments, muscles, joints, tumors and foreign bodies such as splinters. For more information, please follow the link below:

Ultrasound

CT (CAT) Scan

CT uses X-Rays and a sophisticated computer to obtain high-resolution cross-sectional images through the body. CT identifies some fractures which are not visible on plain X-rays. It is very helpful in understanding complicated fractures, bone tumors, and spine disease. CT scan uses more radiation than plain X-Rays, although the dose is still low. Because our goal is to reduce radiation whenever possible, we often prefer to perform ultrasound or MRI in children or pregnant women.

To obtain a CT scan, the patient lies on a table inside a round tube which obtains the X-Rays. The test is very fast, usually taking 5 minutes or less. CT scans for MOI patients are performed at the main hospital or the Imaging Center, and interpreted by the bone radiology team.

CT scan with dye (contrast-enhanced CT)

Sometimes, a dye (contrast) is injected by vein. This dye contains iodine. If you have an allergy to iodine, you should let your doctor and the CT technologist know before the examination. If you have kidney disease or are older than 55 years old, your doctor will check your kidney function before the examination is done. For more information, please follow the link below:

CT scan with dye (contrast-enhanced CT)

MRI Scan

Magnetic Resonance Imaging (MRI) scan uses a strong magnetic field to image the body. It does not use radiation. Similar to CT, the patient lies on a table inside a round tube. The test requires 30-60 minutes to perform. There are no known risks to MRI, but if you suffer from claustrophobia (fear of enclosed spaces) you may wish to ask your doctor for Valium to help you stay still during the exam.

MRI Scan

MRI scan with dye (contrast-enhanced MRI)

Sometimes a dye (contrast) containing gadolinium is given by vein for MRI. This can be used after spine surgery, to tell the difference between scar tissue and a herniated disc. It can also be used to evaluate infection, inflammation and tumor. Gadolinium is usually safe, but can cause severe problems in patients with kidney failure. If you have a history of kidney disease or are over age 55, your doctor will check your kidney function before you are given gadolinium. For more information about problems of MRI dye in patients with kidney failure, follow the link below.

MRI scan with dye (contrast-enhanced MRI)

Arthrogram

Arthrograms use dye injected into the joint in order to improve the doctor’s ability to see problems with cartilage and other structures in the joint. The injection can be performed with X-Ray or ultrasound guidance, and is followed by CT scan or MRI scan. Doctors choose among those options depending on what will be best for a particular problem. Arthrograms are a safe procedure. Very rarely, an infection occurs. This presents as pain, swelling and fever usually more than a week after the arthrogram. Fairly commonly, the patient has pain the day after the arthrogram due to a reaction to the dye used. The pain can be treated with Tylenol, Motrin or other pain medications, or Benadryl. For more information, follow the link below.

Arthrogram

Joint and Tendon Sheath Injections for Pain

Painful joints can be treated with steroid injections. Cortisone is the steroid that most people are familiar with; today, doctors usually use other types of steroids. The steroid decreases inflammation present in arthritis. For some joints, the injection doesn’t require imaging guidance, but some joints require imaging guidance for accurate injection. Guidance can be performed with ultrasound or X-rays. There is a very small risk of causing infection. Steroids are strong medications, and there is some absorption into the blood stream. Diabetic patients may experience an increase in blood sugar after an injection.

Ultrasound is used to guide injection of tendon sheaths. Most tendons are surrounded by a small amount of fluid inside a sheath. The fluid and the sheath reduce friction. However, when the tendon sheath becomes inflamed, the tendon becomes painful and may not move well. The steroid injection decreases the inflammation in the sheath and allows the tendon to move freely.

Epidural Steroid Injection

Epidural steroid injections are performed to decrease inflammation of the nerves in the spinal canal. X-ray is used to guide the injection. For more information, follow the link below.

Epidural Steriod Injection




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