In addition to x-rays, orthopedic physicians use a variety of diagnostic
tests to help identify the specific nature of your musculoskeletal
injury or condition and to guide the best treatment options.
This is a test used to help diagnose the cause of unexplained joint
pain. It uses a contrast iodine solution that is injected into the joint
area to help highlight the joint structures such as the ligaments,
cartilage, tendons and joint capsule. Using a special piece of x-ray
equipment called a fluoroscope the doctor can view images of your joint
in various positions.
Bone and Muscle Biopsy
This procedure involves taking a small sample of bone or tissue and
cells from a specific muscle through injection or incision, and
examining it under the microscope to confirm a possible infection,
cancer or muscle and bone disorders. The sample is usually taken from
bones that are close to the skin surface, away from internal organs or
large blood vessels. The muscle selected for the biopsy depends on the
location of symptoms that may include pain or weakness. The muscles
often selected for sampling are the bicep (upper arm muscle), deltoid
(shoulder muscle), or quadriceps (thigh muscle).
One type tests the density of the bone and is used to diagnose
osteoporosis. The DEXA test, or dual-energy x-ray absorptiometry, is the
most widely used test for measuring bone density in people with
osteoporosis. The technology takes accurate pictures of the hip, spine,
wrist or total body and calculates the density of the done. It can also
help determine your risk for fracture. The second type of bone scan uses
a mildly radioactive substance that is found naturally in your body
where there is bone formation to identify areas where there is unusually
active bone formation and to pinpoint fracture sites or the presence of
arthritis, infection or cancer. The images will show areas of abnormal
bone formation as brighter than the rest of the skeleton.
Computed Tomography (CT Scan)
This type of scan combines X-rays with computer technology to produce a
more detailed cross-sectional image of your body. Your doctor may use
the test if a tumor is suspected or a fracture that does not appear on
x-rays, as can happen in fractures of the collarbone and pelvis. The
test is also used when there has been severe trauma to the chest,
abdomen, pelvis or spinal cord. Sometimes you may be required to drink
or be injected by barium sulfate or a dye so that certain parts of your
body can be seen more clearly in the images.
Intrathecal Contrast Enhanced CT Scan
This test uses the injection of a contrast dye into the spine to better
visualize the spinal canal and nerve roots in the spine. Helps diagnoses
back problems such as spinal stenosis, especially in people who cannot
have an MRI.
This test is used to determine whether the discs, the cushioning pads
that separate the bones of the spine, are the source of your back pain.
The test may also be performed before surgery to identify the specific
discs that are affected. A needle with contrast dye is inserted into one
or more discs and the scan shows any changes in the disc size or shape.
If the orthopedic specialist suspects you may have a blockage in the
blood vessels of your legs or arms, this ultrasound test will be needed
to confirm. The test uses high-frequency sound waves that echo off of
the body to create a picture of the blood vessels.
Electromyography and Nerve Conduction Study
These tests show the functioning of the nerves in the arms and legs.
Fractures may pinch or tear nerves and the EMG is used to identify the
damage if nerve function has not returned with four months of the
injury. Small, thin needles are placed in the affected muscles to record
the electrical activity that is broadcast on a TV-like screen. A nerve
conduction study may be recommended if you have symptoms of carpal
tunnel syndrome. Electrodes are taped to your skin along the nerve
pathway and stimulated with an electric current. The electrodes measure
the speed of the current. If the nerve is damaged, the signal will be
slower and weaker than the normal speed of 120 miles per hour. By
stimulating the nerves at various places, the doctor can determine the
specific site of the injury.
Flexibility, Strength and Range of Motion Tests
These tests are used to determine the strength and range of motion in a
joint and show whether you have a muscle imbalance or arthritis in a
joint. The test can also help determine if there is progression of a
condition such as shoulder impingement or a sprain. There are many
different kinds of flexibility tests geared to specific joints and
muscles Because the muscles are soft tissues, they do not appear on
x-rays. Weakness in a muscle can indicate injury to the bone or nerves.
The resistance tests show muscle strength while the range of motion
tests show how well you can move a joint.
Joint Aspiration and Analysis
Joint aspiration may be both a diagnostic test and a treatment option
for conditions such as bursitis, where there is fluid buildup that
results in swelling and pressure. A similar fluid buildup can occur
around the joints with injures and arthritis. Aspiration involves
removing the fluid through a syringe that relieves the swelling and the
pressure. Analyzing the fluid in a laboratory after removal can help
determine if there is a fracture, infection or inflammatory response
Magnetic Resonance Imaging (MRI)
The magnetic resonance image test uses magnetic fields and a computer to
take high resolution pictures of your bones and soft tissues, resulting
in a cross-sectional image of your body. It can be used to help diagnose
torn muscles, ligaments and cartilage, herniated disks, hip or pelvic
problems and other conditions. The radio waves cause your tissues to
resonate and the computer records the rate at which your tendons,
ligaments and nerves give off these vibrations and translate this into a
This test uses X-rays and a contrast dye to make pictures of the bones
and the fluid-filled space between the bones in your spine. The test is
done to find a tumor, an infection, problems with the spine such as a
herniated disc, or spinal stenosis - the narrowing caused by arthritis
of the spinal canal that holds the spinal cord, spinal nerve roots and
the fluid-filled space between the bones in your spine. Myelograms can
help identify the cause of pain that cannot be found by other tests such
as an MRI or CT scan.
For more information, call 1.866.CALL.MLH.