Musculoskeletal radiology

It uses low-dose X-rays for the basic study of bone and joint diseases throughout the body.

How it is performed
No preparation is required. Arranged in predefined positions depending on the type of examination and skeletal segment to be examined, the patient feels no discomfort, and images are acquired in a few moments. Given the use of ionizing radiation, however low-dose, women of childbearing age are asked about whether they are pregnant, to assess the risk/benefit ratio.

It uses ultrasound and is particularly effective in osteoarticular pathology. Rarely, it may be combined with injection of contrast agent (Sonovue) to sensitize the examination.

Principal indications
In ultrasonography, examinations are performed:

• Muscular, tendon and ligament, with standard technique and elastosonographic study, at rest or with functional (dynamic) study.
• Articular (e.g., shoulder, hands and wrists, hip, ankle, and foot).

How it is performed.
No preparation is required. Arranging the patient in predefined positions depending on the type of examination and the part to be examined, the study is performed with an ultrasound probe. In a few minutes, the necessary images are acquired without any discomfort being felt.

Computerized axial tomography (CT or simply CT) is a radiological examination that allows the visualization and study of various body districts due to the fact that X-rays, emitted by an X-ray tube, pass through organs and are captured by special sophisticated detectors. To improve image quality and allow characterization of possible pathology, intravenous administration of an iodine-based contrast agent may be indicated.

Modern CT equipment that reduces radiation to below the threshold doses required by national regulations.

Principal indications
Among other things, CT is indicated for the in-depth study (Level II) of bone and joint pathologies of the whole body.

Examinations are performed:

• Muscular, tendon and ligament, with standard technique, or with administration of intravenous contrast media.
• Articular, with standard technique or with administration of intravenous or intra-articular contrast media (Arthro-CT).

How it is performed
No preparation is required. The patient is placed lying on the CT table, in predefined positions depending on the type of examination and skeletal segment to be examined. The CT examination is very quick (a few minutes), but considering the preparation and resetting phases, the patient remains inside the radiology department for about 15-20 minutes. Given the use of ionizing radiation, however low-dose, women of childbearing age are asked about any pregnancy status, to assess the risk/benefit ratio.

In cases where intravenous contrast medium is to be injected (very low probability), fasting and creatinine assay by preliminary blood sampling are recommended.

Magnetic resonance imaging is an examination that allows visualization of various body districts without the use of ionizing radiation, but by exploiting the magnetic properties of the body placed in a magnetic field.

Main indications
In magnetic resonance imaging, examinations are performed:

• Muscular, tendon and ligament, with standard technique, or with administration of intravenous contrast agents.
• Articular, with standard technique or with administration of intravenous or intrarticular contrast media (Arthro-RM).

How it is performed
No preparation is required. The patient is placed lying on the MRI table, in predefined positions depending on the type of examination and skeletal segment to be examined. In about 20 to 30 minutes, the necessary images are acquired. Noise is heard during the examination (protective ear muffs are provided) and a sensation of heat may be experienced, especially on 3 Tesla devices. Because of the presence of a magnetic field, women of childbearing age are asked about whether they are pregnant, to assess the risk/benefit ratio.

Contraindications
Patients with pacemarkers, neurostimulators, cochlear implants, intra-orbital metal foreign bodies or intra-cranial vascular clips, some old heart valves. It is recommended to inform the radiology staff promptly of the presence of any devices in your body in order to verify their compatibility with the examination. Surgical clips or staples previously implanted in other parts of the body (chest, abdomen or pelvis in particular) are not a problem. No contraindications either for medical prostheses (hip, knee or other), which, however, may reduce the quality of the examination depending on their location.