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Radiology

Ultrasound, MR arthrography enhance musculoskeletal imaging tools

12/01/2007

In addition to the latest radiographic, magnetic resonance imaging (MRI) and computed tomography (CT) equipment, UCLA radiologists and technologists use ultrasound and MR arthrography imaging techniques to enhance diagnostic capabilities for certain musculoskeletal injuries and disorders. These tools offer orthopaedic and rheumatology patients the complete array of diagnostic modalities.

Ultrasound

Specially trained musculoskeletal imaging specialists at UCLA use ultrasound to produce images of the highest possible resolution of injuries or pathologies involving muscles, tendons, ligaments and soft tissues.

The portable, non-invasive technology is ideal for pinpointing muscle strains as well as ligament and tendon tears, including damage to the shoulder’s rotator cuff or the ankle’s Achilles tendon. In addition, ultrasound is valuable in diagnosing early inflammatory changes of arthritis, identifying soft tissue calcification, and locating fluid collections, hemorrhage or masses within muscles and joints.

Because ultrasound produces dynamic, real-time images, the technology also offers unique capabilities in evaluating patients suffering from snapping tendons, clicking joints and other conditions triggered by movement. Patients can trigger and describe their discomfort while technologists look on.

Ultrasound has no side effects and is a good alternative for diagnosing a wide range of musculoskeletal difficulties in patients unable to undergo MRI due to claustrophobia, pregnancy or pacemakers.

MR arthrography

Magnetic Resonance (MR) arthrography is ideal for detailing abnormalities in very small structures, such as the cartilage lining the hip and shoulder joints. This cartilage may tear acutely or degenerate over a longer period of time. Tears of the labrum (outer wedge of cartilage) of the hip and shoulder are also common disorders that can cause significant pain and disability, especially in younger and athletic individuals.

The procedure involves using a slender needle to inject contrast agent (gadolinium) into the joint before performing an MRI scan using special settings. The contrast seeps into the tear and allows better detection of pathology which may not be recognized on conventional MRI scans. The damage appears as a bright line on the MR arthrography scan. Results are usually available the same day.

At UCLA, radiologists use a fluoroscope when injecting the dye in order to guarantee the contrast reaches the target location inside the joint. Patients may feel soreness from the shot, and the joint may feel heavy or distended for several hours after the injection. Patients may resume normal activities immediately after the procedure.

MR arthrography is most commonly indicated for patients with clinical signs and symptoms suggesting a labral tear, such as pain that occurs in certain positions or occurs intermittently.

Standard MRI scans typically are used for evaluation of larger structures of the shoulder joint, such as the bones and rotator cuff. For patients with inability to extend the arm over the head, standard MRI would be an appropriate first test.

UCLA musculoskeletal radiology

Technologists and radiologists at the UCLA Musculoskeletal Imaging Section perform the full range of musculoskeletal diagnostic imaging techniques for orthopaedic and rheumatology complaints. Faculty and technologists have a very close working relationship with the UCLA Department of Orthopaedics, and conduct joint conferences and research endeavors with that department.

Physicians

Leanne Seeger, M.D.
UCLA Professor of Radiology
Section Chief, Musculoskeletal Radiology

Kambiz Motamedi, M.D.
UCLA Assistant Professor of Radiology
Director, Musculoskeletal Imaging Fellowship Program

Kira Chow, M.D.
UCLA Assistant Professor of Radiology

Patient referral

Physicians may refer patients for diagnosis of musculoskeletal diseases, disorders and injuries by contacting the UCLA Department of Radiology  at (310) 301-6800 and fax the order to (310) 794-9035.

For more information about the UCLA Department of Radiology and the Musculoskeletal Imaging Section, visit www.radiology.ucla.edu.





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