Evaluation Procedures

What are standard evaluation procedures?

Before a treatment or rehabilitation protocol can be established, your orthopaedist must first determine the reason for, and source of, your condition. This typically involves a comprehensive physical examination and a detailed medical history profile, in addition to a complete history and description of the symptoms related to your condition. During this initial gathering of information, be sure to notify your physician of any other illnesses, injuries, or complaints that have been associated with the pain or condition, as well as any previous treatments or medications prescribed. Preliminary diagnostic tests may then follow, including blood tests and/or x-rays.

Advanced evaluation procedures:

Patients who require further evaluation may undergo one or more of the following:

• x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
• arthrogram - an x-ray to view bone structures following an injection of a contrast fluid into a joint area. When the fluid leaks into an area that it does not belong, disease or injury may be considered, as a leak would provide evidence of a tear, opening, or blockage.
• magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body; can often determine damage or disease in a surrounding ligament or muscle.
• computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
• electromyogram (EMG) - a test to evaluate nerve and muscle function.
• ultrasound - a diagnostic technique which uses high-frequency sound waves to create an image of the internal organs.
• laboratory tests (to determine if other problems may be the cause)
• arthroscopy - a minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube (arthroscope) which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen; used to evaluate any degenerative and/or arthritic changes in the joint; to detect bone diseases and tumors; to determine the cause of bone pain and inflammation.
• myelogram - involves the injection of a dye or contrast material into the spinal canal; a specific x-ray study that also allows careful evaluation of the spinal canal and nerve roots.
• radionuclide bone scan - a nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient's bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.

After the evaluative information is collected and reviewed, the orthopaedist will discuss the treatment options with you, in order to help you select the best treatment plan that promotes an active and functional life.