Innovative Technologies …
The best management for arthritis patients identifies what type of arthritis is involved and to stage and monitor the progression. In evaluating patients, different imaging tools are used. Conventional x-rays are not always that helpful because they do not show early changes of arthritis damage. Listed below are some of the newer imaging studies that are used.
Musculoskeletal Ultrasound [MSUS]
MSUS has become an important diagnostic tool to evaluate different types of arthritis and stage the severity of disease. Common types of arthritis, like osteoarthritis, rheumatoid arthritis, gout and pseudo gout arthritis, can be better diagnosed with MSUS than xay.
MSUS can aide in aspirating fluid and injecting a joint such as a Baker’s cyst of a knee or a Carpal Tunnel at the wrist.. We can see the tip of the needle as the fluid is being removed. The medication can be more accurately placed.
MSUS is also used to examine structures around joints such as tendons, bursa and ligaments. Musculoskeletal ultrasound is very safe and does not involve any x-ray radiation.
MSUS detects potential damage to the joint much earlier than x-ray. The presence of early disease will often dictate a more proactive and assertive course of treatment that can prevent possible further damage and deformity.
Magnetic Resonance Imaging [MRI}
MRI technology has become an important tool for the diagnosis and staging of many types of arthritis. This technology offers greater sensitivity to visualize early changes in and around joint structures. The presence of early disease will dictate a more proactive and assertive course of treatment that can prevent possible further damage and deformity guide and direct different treatments that may help to treat the patient earlier and prevent further damage.
DEXA [Dual Energy X Ray Absorbtiometry]
Bone mineral density (BMD) testing uses a special machine (DEXA) to measure one’s bone density to determine if a patient is at risk for fracture and osteoporosis. This is a painless test that takes about 15-20 minutes to perform. Images of the spine, hip and forearm are measured. A FRAX calculation is measured which more accurately determines a patient’s risk for fracture.
DECT Scanning [Dual Energy Cat Scan]
DECT Scanning is now available to help diagnose and stage patients who have moderate and severe gouty arthritis. X-rays often do not show the presence of uric acid in and around joint structures. Many patients have a high total body burden of uric acid because they have had many attacks of Gout for many years.
DECT Scanning involves the use of two CAT scans and provides a very accurate assessment of the presence of uric acid in and around joints in a colorful presentation.
The procedure is painless and takes several minutes to do. This information can better quantify the amount of uric acid in and around joints where there has been an acute attack as well as those joints that may be asymptomatic.
The photos below show large deposits of uric acid [in green color] in the feet of a patient with gout.
|Left Foot|| Right Foot
|Click photos for large view.|