7.1. METHODS OF IMAGING STUDY
The main and primary method of examination of the musculoskeletal system in most cases is the radiologic method. As a rule, each examination begins with radiography in order to detect pathological changes in the bones. The exception is the use of CT in the emergency diagnosis of damages to the head (skull), spine and pelvis, as well as the use of ultrasound and MRI in a focused study of blood vessels, muscles, tendons, ligaments.
The further examination of the patient is based on the principle of optimal sufficiency, that is, the most effective methods and techniques of diagnostic radiology are used for characterisation of specific changes.
In the future, the development of computer technology will allow simultaneously obtaining a set of planar and three-dimensional images of the musculoskeletal system, which will lead to a reduction of the number of additional radiation studies.
7.1.1. The radiological method
In a radiological examination of bones and joints, this method is the main one. Usually, the radiography is used in the primary examination. Basic requirements for radiography are:
► to carry out radiographs in standard patient positioning and with at least two mutually perpendicular views;
► the image shows two or at least one joint, the nearest to the area under study;
► to use additional patient positioning in the study of complex anatomical structures.
Roentgenoscopy (X-ray television visualization) is used to study the kinematics of the joints, perform functional tests, obtain enlargement radiographs of the areas of interest, and control manipulations during surgery.
Linear tomography is used for a more detailed assessment of the changes in bone structure, including destruction and neoplasms of bones, the formation of callus in fractures, etc., (if it is impossible to use CT or MRI).