Musculoskeletal imaging is a type of medical imaging. Doctors use these techniques to look at the bones and joints. It’s also how they see inside soft tissues like muscles, tendons, ligaments and cartilage.

It helps doctors diagnose injuries, diseases, or health issues that affect movement or cause pain. A radiologist with expertise in musculoskeletal imaging will take the images and analyze the results.

Musculoskeletal imaging can help if you're having pain, swelling, or trouble moving part of your body. It gives doctors a closer look at your bones, joints, and soft tissues so they can find the cause and choose the right treatment.

Common reasons your doctor might order this type of imaging include:

• Sports injuries, like torn ligaments or broken bones
• Arthritis, joint pain or swelling
• Bone infections
• Tumors in bones or soft tissue
• Unexplained swelling or pain

Osteoporosis screening is an imaging test that looks for signs that your bones are getting weaker. It's also called a bone density scan or dual X-ray absorptiometry (DEXA) scan. It's a low-dose X-ray that measures calcium and minerals in your bones.

It helps us:

• Diagnose osteopenia, which is low bone mass
• Diagnose osteoporosis, which is porous bones
• Predict your risk of future fractures
• See if osteoporosis treatment is working

Different imaging exams can help find problems in muscles and bones.

Bone imaging

These tests help us look closely at your bones. They can find fractures, infections, cancer, or other health issues.

Imaging methods often used to see muscles and bones include:

• X-rays: This test uses a small amount of radiation to take quick pictures of bones. They’re best for spotting fractures, dislocations, or signs of arthritis.
• Computed tomography (CT) scan: This is a type of X-ray that takes many images from different angles to create a cross-sectional view. It’s useful for seeing complex bone injuries or joints in more detail.
• Magnetic Resonance Imaging (MRI): This scan uses magnets and radio waves (not radiation). It creates very detailed images of soft tissues and even bone marrow.
• Ultrasound: This test uses sound waves to create real-time images of soft tissues. It’s also helpful for guiding procedures like joint injections or biopsies.
• Bone scan (scintigraphy): This scan images your bones with a small amount of radioactive material and a special gamma camera. We may use it when an X-ray doesn’t clearly show the problem. The scan highlights areas with more bone activity, including infection, injury, or cancer.
• Single-photon emission computed tomography (SPECT): This scan mixes a bone scan with 3D tools. It gives a more detailed view of bone activity than a standard bone scan. This can be especially useful for complex areas, such as the spine or joints.

Spine imaging

These imaging tests focus on the bones, discs, and nerves in your spine to help find the cause of back or neck pain.

• Spine CT: This scan shows the bony structures of your spinal column. It can help us diagnose fractures, infection, and degenerative diseases, such as arthritis. It can also help us see narrowing of the spinal canal that holds the spinal cord.
• Spine MRI: This imaging technique creates detailed pictures of the spine and surrounding tissue. We may use it to diagnose tumors, birth defects, injury, infection, or disease. It can also show compression of the spinal cord and nerves.
• Discography (discogram): We use imaging to inject a special dye into the center of one or more of your spinal discs and then take a picture of it. Also called a discogram, it helps us see whether discs are the cause of back or neck pain.

Soft tissue and joint imaging

Soft tissue and joint imaging gives clear pictures of muscles, joints, tendons, and ligaments. The most commonly used imaging technique is a musculoskeletal ultrasound.

The ultrasound machine can take pictures of the soft tissues from the outside of your body. It’s a hand-held wand that doctors can even use at your bedside.

We may use it to diagnose arthritis, sprains, tears, pinched nerves, and other related health issues.

Musculoskeletal radiology is the term for imaging procedures on the muscles and bones. These procedures use imaging tools to help guide tests and treatments.

Imaging-guided diagnostic procedures

Some diagnostic procedures use imaging to help us gather tissue samples from the body. We use tissue samples to diagnose cancer, infection, or inflammation. 

• Bone biopsy: We use CT scans or MRI to help find the best place to take a bone sample. You may need a bone biopsy if we suspect bone cancer or infection. We use CT scans for bone marrow aspiration and biopsy to diagnose bone and blood cancers.
• Spinal tap: Also called a lumbar puncture, this is a biopsy of your cerebrospinal fluid to look for infection or disease. We may use fluoroscopy, an imaging tool that turns X-rays into video images. This helps us find the best place to insert a needle to collect the fluid.
• Joint aspirations: This is also called joint drainage. We use imaging to guide a needle into the joint to remove fluid. It can help relieve swelling and pressure. We can test the fluid to look for infection or inflammation.

Imaging-guided spine treatments

With tiny bones and delicate structures, image guidance is often essential for spine procedures. We use them in minimally invasive spine surgery. They can help treat spinal injuries, fractures, or chronic pain.

• Vertebroplasty: We use fluoroscopy to guide a needle into a broken vertebra. Once there, we inject a cement mixture to stabilize the bone. This helps reduce pain and prevent further collapse. We may also use ultrasound or CT scans during or after the procedure.
• Kyphoplasty: We use fluoroscopy to insert a small balloon into the collapsed vertebra. We gently inflate it to create space and fill the space with a cement mixture. It helps restore the bone’s shape and reduce pain. We may also use ultrasound or CT scans during or after the procedure.
• Spinal fusion: We may use X-rays, spine CT, or spine MRI to help plan and fix an unstable spine. Spinal fusion joins together 2 or more bones in the spine so they no longer move.
• Radiofrequency ablation (RFA): We use radio waves to heat and destroy damaged nerve tissue and diseased bone. It stops pain signals from reaching the brain. We use it to ease pain from spinal nerve damage, bone lesions, and cancer.
• Percutaneous disc decompression: We use imaging, such as fluoroscopy or CT, to guide a needle into a damaged or bulging spinal disc. We remove a small amount of disc material to relieve pressure on the nerves. This procedure may help ease pain, numbness, or weakness caused by a herniated disc.

Imaging-guided procedures for joints, muscles, and tendons

Imaging guidance is essential for many soft tissue treatments. These procedures use imaging tools to treat issues in the joints and tendons.

• Joint injections: We use ultrasound to help find the best place to inject medicine directly into a joint. These injections can reduce pain and swelling, especially if you have arthritis or a pinched nerve.
• Tendon release: We use ultrasound to guide a needle to break up scar tissue in a swollen tendon. We can do this through the skin (percutaneous). It can help encourage healing, reduce pain, and improve your range of motion.