Many orthopaedic conditions can be diagnosed in the office. Your orthopaedist will ask you to perform some simple movements
that will give information about your range of motion, flexion, muscle tension and areas of pain. If your condition doesn’t
improve after a few weeks of conservative treatment or you have been severely injured, you may have to undergo medical tests
to pinpoint the source and extent of injury. Such tests aid your doctor in diagnosing your problem and in developing an appropriate
treatment plan. Click a link below to learn more about common diagnostic orthopaedic tests.
Arthrocentesis is also called joint fluid analysis. This procedure can help find the cause of joint pain or inflammation, or can also be
used to treat excessive fluid buildup in the joints. During arthrocentesis, your orthopaedist will insert a long, thin needle
into your joint and remove a small amount of joint fluid. The fluid will be tested at a lab for signs of infection, bleeding
and other problems. This procedure is done most often on knees, but can also be done on the shoulder, hip, elbow and wrist.
Arthroscopy is a minimally invasive procedure in which your orthopaedic surgeon examines the inside of one of your joints with an arthroscope.
This is a pencil-sized instrument with a lighted viewer attached to a TV monitor. Your orthopaedist may need to see inside
your knee, elbow, shoulder or ankle to find out what is causing joint pain or inflammation. Orthopaedic surgeons can also
perform surgery with the arthroscope, removing loose pieces of cartilage or repairing torn ligaments.
Bone mineral density is the measure of calcium in a specific section of bone, which can help your doctor estimate how strong your bones are. This
a test performed on patients with osteoporosis. Minerals such as calcium are continually being added and removed from your
bones as your body uses them. When minerals are taken from bone faster than they are replaced, the bones become weaker, less
dense and more likely to break. Several different tests can help doctors measure bone density, including DEXA scans.
Bone scans are performed by injecting a radioactive tracer into your body, then after the tracer has moved through your body and into
your bones, taking pictures of your bones with a special camera. Any areas of bone that are under repair or growing quickly
will absorb more of the tracer than other areas. Bone scans can identify bone lesions that may not be identified in other
tests such as tumors, fractures or infections. This test can be used to help diagnose unexplained bone pain, metastatic cancer,
stress fractures and other problems.
CT scans (computed tomography scans) are complex X-rays that produce detailed, cross-sectional pictures of the structures inside your
body. Like an X-ray, a CT scan passes beams of radiation through the body to record images of it on film. A computer then
formats the pictures into slices or cross-sections of your body and enhances detail. Dense tissues such as bones appear white
in the CT scan, less dense tissues (for instance, muscles) come up gray and air-filled tissue (such as lungs) appears black.
Sometimes a special dye is injected before a CT scan to make certain blood vessels or organs more visible. CT scans can help
detect spinal tumors, injuries, deformities, spinal stenosis and ruptured discs. CT scans should not be performed on women
who may be pregnant.
DEXA scans (Dual-Energy X-ray Absorptiometry scans) are tests performed to measure bone density and to assess your risk of bone fracture.
These scans help detect osteoporosis. During the test, low-energy X-rays pass through your body like a flashlight beam and
the calcium in your bones blocks the beams. These blocked areas form images of your bones on the film; areas of bone that
have lost calcium will show up darker. DEXA scans are typically taken of the hip, spine or forearm.
Electromyography (EMG) testing measures electrical activity that occurs when muscles contract. Nerves control muscles to the body through
electrical impulses. When muscles move, they also emit electrical impulses. Electromyography helps diagnose disorders that
damage muscle tissue, nerves or the junctions between nerves and muscles. These disorders include herniated discs and neuromuscular
diseases such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease).
EMG testing is also used to evaluate numbness, tingling or weakness. During the test, several electrodes are placed on your
skin to measure and compare muscle contractions. A doctor inserts a very thin needle electrode into individual muscles, one
at a time. Electrical impulses caused by this stimulation of your muscles are recorded and measured. This test is often done
in conjunction with nerve conduction studies.
Nerve conduction studies measure electrical activity that occurs when a nerve is stimulated. Nerves control muscles in the body through electrical
impulses. Nerve conduction studies show how well individual nerves transmit these signals. During this test, several electrodes
are attached to your skin and a recording electrode is placed over muscles controlled by that nerve being studied. While a
special instrument sends short electrical pulses to the nerve, the muscle electrode records how quickly the nerve transmits
that electrical message. Nerve conduction studies help doctors determine the presence, location and extent of nerve damage
that can occur in carpal tunnel syndrome and other disorders. These studies are often done in conjunction with electromyography.
Magnetic Resonance Imaging (MRI) uses a magnetic field and radio waves to create images of your organs and other structures inside your body. Bones don’t
show up well on MRI, but tissues and organs containing water do. That’s why MRI is a useful imaging tool for detecting conditions
that increase fluid in tissues such as inflammation, infection, tumors and internal bleeding. Some orthopaedic conditions
that MRI can help evaluate include arthritis, bone tumors, bulging discs, cartilage problems, ligament tears and spinal stenosis.
Myelography is an X-ray study of the spinal canal. A special dye is injected into the space that surrounds the spinal cord and nerve
roots so they will be visible on X-rays. Myelography may be used to find ruptured discs, spinal tumors, spinal cord inflammation,
and spinal nerve problems.
Somatosensory evoked potentials are studies that record electrical activity on nerve pathways that run from the arms and legs through the spinal cord to
the brain. Electrodes are placed on the scalp and along the spinal cord, then a small electrical current is applied to the
skin overlying nerves on the arms or legs. The current creates a tingling sensation but is not painful. Each leg or arm is
tested separately. These studies helps evaluate spinal cord function.
Ultrasound uses sound waves to create images of tissues underneath your skin. This may be used to diagnose such injuries as rotator
cuff tears.
X-rays are the most common and least expensive form of imaging. X-rays, like light or radio waves, are a form of radiation. X-rays
pass through the body like a flashlight beam and the calcium in your bones blocks the beams. These blocked areas form images
of your bones on the film. Because nerve roots and discs in your spine don’t have calcium, X-rays won’t show these structures.
X-rays are mainly used to learn if a bone is fractured, injured or damaged. Pregnant women should avoid X-rays.
