Many musculoskeletal conditions can be diagnosed on the based upon careful questioning and a thorough physical examination. Imaging tests, laboratory tests or other diagnostic procedures are sometimes needed to help make or confirm the diagnosis.
X-rays are quick and simple way of detecting bony problems, such as a suspected fracture. They are used to also to rule out problems such as arthritis, infection, tumours, or deformity. X-rays do not show soft tissue problems such as tendon, ligament or muscle injury.
CT (computed tomography) Scan
CT scans are best at looking at bone, but give much more detail than ordinary X-rays. They are useful for finding fractures or bony problems that are not visible on normal X-rays.
MRI (magnetic resonance imaging) Scan
MRI scans are excellent at looking at soft tissues such as muscles, ligaments, tendons and cartilage. At International Orthopaedic Clinic we understand that some patients feel claustrophobic in a normal MRI scanner. We have access to open scanners which will make you feel more comfortable.
Ultrasound is a fast and simple way to identify inflammation around joints and tendon tears. It is also useful to guide a needle into a joint.
Blood tests may be useful to diagnose a musculoskeletal disorder that is affecting the entire body, not just one joint.
In rheumatoid arthritis, an autoimmune disease which can destroy any joint as well as affect organs, a blood test to identify rheumatoid factor or anti CCP antibodies may be helpful in making a diagnosis.
In ankylosing spondylitis, a disorder that may affect the back, pelvic bones and hip joints in young people, a blood test to detect a particular gene (HLA-B27) can be used to identify this disease.
If these disorders are detected then the conditions are managed together with a rheumatologist, a Infection and inflammation may be detected and monitored using several blood tests that detect inflammatory markers such as the white cell count (WCC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
Nerve conduction studies (NCS) and Electromyography (EMG) are tests used to give information about the health of nerves and muscles. Nerve conduction studies may be used to determine whether there is a trapped nerve, causing pain and numbness. A common condition caused by nerve entrapment (of the median nerve at the base of the wrist) is carpal tunnel syndrome, where sufferers experience pain, muscle weakness and numbness of the thumb and several fingers. Some patients may benefit from surgical release of the trapped nerve.
Dr Alan Cheung is a Consultant Orthopaedic Surgeon specialising in Sports Injuries such as torn ligaments and tendons, and cartilage injury in the knee, hip and shoulder, Adult Joint Reconstruction including total and partial Knee Replacement and Total Hip Replacement for osteoarthritis, and Robotic Surgery (Makoplasty, Navio and Robodoc systems). He has also received extensive training in trauma (fixing broken bones) and musculoskeletal tumour (bone cancer) surgery.