Radiology or X-rays usually form the baseline investigation of most orthopaedic problems. The fact that mainly bones and joint degenerative changes (such as in hip arthritis or knee arthritis) may be seen on the radiographs limits these studies. Another significant disadvantage of X-ray investigations is the ionising radiation dose which is delivered to the body during the procedure. While X-rays are often necessary for diagnosis and follow-up of orthopaedic conditions, our practice requests them only when necessary and we are able to recommend better radiological investigations, which do not involve ionising radiation, in many cases. As always, a thorough clinical examination prior to a decision regarding the most appropriate imaging modality is of paramount importance. Specific radiographs (such as mechanical axis views) may be required for pre-operative planning of hip replacement and knee replacement procedures.
Modern radiological investigations such as Ultrasound, CT scans as well as MRI scans are used extensively to pin down diagnoses in patients with degenerative joint disease as well as sports injuries. MRI and ultrasound do not involve ionising radiation and are therefore significantly safer.
MRI images are derived from the resonance of millions of Hydrogen atoms in the human body when these are aligned in a magnetic field. These scans have revolutionised the diagnosis of soft tissue pathology in orthopaedics and have a major place in the diagnosis and grading of sports injuries such as knee ligament injuries (ACL, PCL, LCL, MCL), hip labrum injuries and many others. Pre-operative assessment of patients with meniscal tears and/or focal knee cartilage injury often includes MRI scanning prior to arthroscopic surgery.
Ultrasound scanning is an investigation which involves high frequency sound waves which penetrate the soft tissues and are reflected variably by structures in the body. A transducer picks these reflected ultrasound waves up and creates an image on a monitor, which is interpreted by a radiologist. Conditions such as tendonitis as well as muscle tears and fluid collections such as occurs with bursitis lend themselves to ultrasonic investigation.
CT scans are computer-generated 2D and/or 3D images which are derived from multiple X-rays which are taken at various angles. These scans show mainly bone and may be used to plan surgical intervention in cases of difficult fractures around the major joints. CT scans are also frequently utilised in the pre-surgical planning of hip replacement revisions as well as knee replacement revisions with extensive bone loss.
The surgeons at the Cape Joint Surgery maintain an excellent relationship with the radiologists at Cape Radiology through formal imaging review meetings as well as ad-hoc patient-specific consultations with a view to improved patient diagnosis and care.
Radiological investigations from other practices are available to us online and do not need to be repeated when a patient comes to see us (for example for a second opinion) – a compact disc (CD) containing the relevant data (as opposed to the old X-ray packet containing radiographs) should be available to all patients after they have undergone any form of digital imaging or Radiology.
