Radiology London | Joint Arthritis Luton | Spinal Fractures Hatfield

What is a Radiology Examination?

A radiology examination utilises the technology of imaging to diagnose various disorders in minimal duration of time. The techniques provide images of bones and soft tissues to enable obtaining a diagnosis. A radiologist is a medical doctor specialising in the interpretation of the results of the imaging techniques (X-ray, CT-scan, MRI), but is also highly trained in performing ultrasound scans and image-guided procedures.

Types of Imaging:

X-Ray

X-ray technology is used best for the examination of bones; looking at spinal alignment, deformity, joint arthritis and fractures.

An X-ray procedure typically involves the following steps:

Lying or standing, or holding a certain position, depending on the part of your body to be imaged.
The X-ray machine captures an image of the specified region.

Magnetic Resonance Imaging (MRI)

This is a computer-based imaging technique that creates a magnetic field inside your body to obtain images. This technique is effective in diagnosing a variety of spine pathologies, such as slipped discs and nerve entrapment. It is also widely used in paediatric orthopaedic conditions to assess for anatomical detail and pathology. It does not use radiation and therefore does not cause any radiation damage.

An MRI imaging procedure involves the following steps:

You must not wear any metal (as the machine uses a very strong magnet), and you will have to remove hearing aids, wigs, watches, or eyeglasses.
You may need to have an IV line started in your arm if the MRI requires contrast dye. Inform your technician if you have or feel any allergy symptoms such as sneezing or itching.
You will lie on a table which slides inside the MRI machine.
It is normal to hear loud tapping sounds during the scan.

Computed Tomography Scan (CT-Scan)

Computerised tomography (CT) scan is an imaging technique that uses a combination of a special X-ray machine and a computer to obtain cross-sectional images of the internal structures of the body. It also allows for 3D reconstructions of the spine, bones and joints to plan for surgery. It involves the following steps:

You will wear a hospital gown and lie on a table that is attached to the CT scanner.
Speakers inside the scanner enable you to communicate with the technician.
The table will slide into a large donut-shaped machine which takes images while moving around specific parts of your body, yielding several images or “slices” from different angles. It is normal to hear loud, clicking sounds. A computer will transform the slices into 3-dimensional images for your doctor to view.
You may be asked to hold your breath for a few seconds during image capturing.
You are removed from the scanner once the procedure is completed.

Ultrasound (US)

An ultrasound is an imaging technique commonly used to examine a baby growing in a mother’s uterus but is also used to assess joints, tendons and ligaments etc. The directed sound waves bounce off the specific area to be assessed and are processed to create still images.

The procedure involves the following steps:

You will be sitting on a couch or lying down and will have a gel applied to the skin over the site to be examined.
A transducer (handheld instrument) will be gently glided over the gelled area.
The transducer emits the sound waves and receives them once they bounce off the targeted area. The gel provides lubrication and enhances the passage of the sound waves.

Image-guided Procedures:

The radiologist can perform a broad spectrum of procedures using imaging to guide the needle to ensure correct site deployment of medications.

US guided: The technology of US as described above is employed to identify the pathology, but also to visualise the needle enter the correct location to ensure maximal benefit from the injected medications.

The following steps are involved:

The skin overlying the injection site will be cleaned to establish a sterile field.
Local anaesthetic will be administered into skin and underlying soft tissues.
The needle will be introduced into the target area with the transducer placed onto your skin.
Once the correct needle position is obtained, the medicine is injected.

You will not be able to drive for 24 hrs after the procedure (due to the effect of the local anaesthetic), so please make arrangements for this.

You must take it easy for 2 days after the procedure, using painkillers as necessary.

CT guided: This technique is used primarily to guide injection into the sacroiliac joints (the junction on each side of your lower spine with the pelvis) and also around nerves as they exit your spine.

The following steps are involved:

You will change into a gown and lie on your stomach on the CT table. We will ensure you remain as comfortable as possible in this position.
A marker is placed onto your skin in order to accurately identify the target. The table will move into the CT scanner and the images are obtained.
The radiologist will mark your skin at the entry point and then clean to ensure a sterile field.
Local anaesthetic will be administered into the skin and underlying soft tissues.
The needle will be inserted towards the target. You will slide in and out of the CT scanner on the table, in between adjustments of needle position.
Once the correct needle position is obtained, the medicine is injected.

Please let us know in advance if you are taking any drugs to thin your blood, such as warfarin etc.