Accurate diagnostic imaging can make all the difference in properly finding the source of muscle and joint pain. At University Radiology, our experts in musculoskeletal imaging offer advanced imaging procedures as well as minimally invasive treatments that can:

• Detect the source of disease within ligaments, tendons and cartilage.
• Remove fluid from joints for testing or to alleviate pressure and joint pain.
• Reduce pain in joints to allow a more active lifestyle.

In some cases, our musculoskeletal interventions may delay or even prevent the need for surgery. The procedures we offer include:

Arthrography

Arthrography is a medical imaging technique to examine joints, including the hips, knees, shoulders and ankles. The procedure uses contrast material (dye) to produce detailed images of the inside of a joint. The images are captured via imaging technologies including CT scans, MRI scans and fluoroscopy - X-ray images that are stitched together to create real-time video.

What are the benefits?

• An effective way to locate tears and other damage to the cartilage, ligaments and tendons of a joint.
• Shows parts of the joint that are not normally seen in other imaging exams.

How does the procedure work?

Your radiologist will numb the area around the joint being studied with a local anesthetic. Using image guidance, he or she will direct a longer needle into the joint. A contrast material (dye) is injected into the joint. This contrast material makes many structures of the joint more clearly visible on the images your radiologist will take using CT scans or MRI scans. Your radiologist may also have you move the joint to capture images from different angles. The arthrogram contrast injection usually takes a few minutes, and the MRI or CT exam that follows may take anywhere from 30 minutes to more than an hour.

Arthrocentesis (Fluid Removal And Therapeutic Joint Injections)

Arthrocentesis is a minimally invasive, image-guided procedure to remove fluid from a joint. Synovial (joint) fluid cushions and lubricates the joint to provide ease of movement. When a joint is injured or arthritic, synovial fluid can accumulate in the joint and cause swelling, pain and stiffness. Arthrocentesis, also known as joint aspiration, removes that extra fluid, reducing pressure and pain. The extracted fluid also may be analyzed for conditions including gout, rheumatoid arthritis and infection.

Using similar techniques, your interventional radiologist may also inject medication, such as a corticosteroid, into the affected joint to temporarily lessen pain or reduce inflammation.

What are the benefits?

• A nonsurgical way to reduce pain and swelling in a joint.
• Helps diagnose common joint problems including infection and gout.
• Therapeutic injections can provide pain relief lasting several weeks without the need for large doses of pain medication.

How does the procedure work?

Your interventional radiologist will numb the affected joint with a local anesthetic. Using image guidance such as fluoroscopy, CT scans or ultrasound, he or she will precisely direct a needle to the site in the joint where synovial fluid needs to be removed. Samples of the fluid are later sent to a laboratory for testing. If a therapeutic injection is being performed, a small amount of a liquid steroid medication will be injected into the joint. The medication can provide pain relief lasting up to 6 to 8 weeks. Both procedures are done on an outpatient basis - you will return home shortly after the procedure.

Tendon Sheath Injections

Tendon sheath injections are used to help relieve painful and swollen tendons - often caused by arthritis or other inflammatory conditions. Tendons connect muscles to bone, and the tendon sheath is a sleeve of tissue around the tendon. If a tendon sheath becomes inflamed, it can fill up with fluid, causing pain and reducing range of motion in a joint. Sheath injections are used to deliver pain-relieving medication around the affected tendon.

What are the benefits?

• Relieves pain and inflammation around tendons from conditions such as arthritis.
• Minimally invasive and patients return home the same day.

How does the procedure work?

Your interventional radiologist will numb the area being treated with a local anesthetic. Using ultrasound or X-ray imaging, he or she will guide a needle into the tendon sheath, a membrane around the tendon. A mixture of steroid medication and anesthetic is injected into the tendon sheath. The needle is removed and the injection site is covered. The procedure takes less than 30 minutes and you will go home the same day.

Bursa Injections

Bursa injections are used to help relieve painful and swollen bursae - small, fluid-filled sacs that allow muscles or tendons to smoothly glide over bones and ligaments. Inflamed bursae most often occur in joints that perform frequent, repetitive motions, including the shoulders, elbows and hips. Bursa injections are used to deliver pain-relieving medication directly into the affected joint.

What are the benefits?

• Relieves pain and swelling caused by bursitis, a common condition among athletes and workers who perform repetitive tasks.
• Minimally invasive and patients return home the same day.

How does the procedure work?

Your interventional radiologist will numb the area being treated with a local anesthetic. Using ultrasound or X-ray imaging, he or she will guide a needle into the bursa, a small, fluid-filled sac that cushions the joint. A mixture of steroid medication and anesthetic is injected into bursa. If there is excess fluid in the bursa, it can be drained immediately prior to the injection. The needle is removed and the injection site is covered. The procedure takes about 30 minutes and you will go home the same day.

Calcific Tendinitis Lavage

Calcific tendinitis occurs when calcium deposits build up in tendons. It most frequently occurs in the rotator cuff tendons in the shoulders, resulting in pain and inflammation. Lavage is a minimally invasive technique to flush the calcifications out of the tendon using a liquid medication solution.

What are the benefits?

• Effective for short term and long term relief of shoulder pain caused by calcium deposits in tendons.
• Minimally invasive and patients return home the same day.

How does the procedure work?

The shoulder is numbed using a local anesthetic. Using ultrasound guidance, your interventional radiologist will direct a needle into the calcification. A liquid solution of saline and a numbing medication is pushed out of the needle's syringe and into the calcification. The solution breaks up the calcification, allowing your radiologist to remove it by drawing it back into the syringe in disintegrated form. Sometimes an anti-inflammatory medication is then injected into the bursa or space around the tendon. The procedure takes less than 10 minutes and you will go home the same day.

Abscess And Cyst Drainage

A cyst is a fluid-filled sac inside the body that can cause pain, but is usually benign. An abscess is a collection of pus that is usually caused by an infection. Both can occur under the skin or inside of the body. Our interventional radiologists treat both conditions using a small needle to drain fluid - a procedure known as aspiration.

What are the benefits?

• Decreases the amount of swelling and pain caused by the extra fluid.
• If there is concern for infection, the fluid can be removed and sent for culture and additional analyses.

How does the procedure work?

After cleaning off the skin, your interventional radiologist will use ultrasound imaging to locate the pocket of fluid. The skin overlying the bump will be numbed with a local anesthetic. A needle, sometimes with a small tube (catheter), will gently and slowly be placed into the area where the cyst or abscess is. The fluid may be drained through the needle, or the needle may be removed and the fluid then drained through the small catheter. When the fluid has drained, the needle, catheter or both are removed and a bandage is placed over the site. Fluid or solid tissue from the cyst or abscess may be sent to a laboratory for testing. The drainage procedure takes about 30 minutes.

For an appointment: Call 800-758-5545 Mon - Fri: 8 am - 8 pm, Sat: 8 am - 12 pm

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