Bones may get affected by medical conditions just like your other organs in your body. This will include certain things such as – inflammation, signs of wear and tear, fractures and cancer. While fractures and injuries are common for young people, diseases such as osteoarthritis and osteoporosis will probably begin to develop. Different examinations and tests are done to find what may be the cause behind difficulty to move or general pain.
X-ray examinations enable to “look through” different parts of your body. When radiation passes through the tissue, this will produce an x-ray image.The bones absorb almost all radiation as they are dense and appear in the form of grey or white outlines on an x-ray image. The soft tissues like muscles or fat allow all radiation to pass through them and so, they do not appear on the x-ray image.
Hence, x-ray examinations are helpful for examining the skeleton however; they are not good for examining soft tissues. X-ray examinations involve direct exposure to radiation and should be done only if medically needed. Pregnant women only have to perform x-rays in rare cases.
X-ray examinations are used to either detect or rule out problems such as signs of wear and tear, fractures and bone inflammations or unusual positions of the bones.
Before performing an x-ray, you need to remove any jewelry and clothing from the body part to be x-rayed. Depending on the part to be examined, you may have to lie down, stand or sit. When the x-ray is performed, your body will be positioned between the x-ray film and the radiation source.Genitals are usually protected from radiation by a lead apron. The medical staff will need to wear lead aprons for further protection and it will take just a few seconds to get the image.
Computed tomography or CT allows you to get more x-ray images of your body. These x-rays are then sent from different directions through the body. CT scans do not include one x-ray image of the body part being examined.Rather,different x-ray images are taken in thin layers.
The computer uses data from individual images to arrange a multidimensional cross-sectional image of the body part that had been scanned. In the CT examinations, people are exposed to high levels of radiation than in x-ray examinations.
Computed tomography may be used to detect changes in bones that are not visible, or can be seen only with conventional x-ray images.
During the examination, you will be shifted to a CT scanner which is ring shaped while lying down.An X-ray source in the CT scanner rotates around your body part that needs to be scanned. Thus, depending on which part of the body needs to be scanned, the process will require anywhere from 5 to 30 minutes in total.
Magnetic resonance imaging (MRI or MRT) produces cross-section images of your body. Other than x-rays, this technique uses radio waves and magnetic fields.
In simple words, the MRI scanner detects the activity of hydrogen atoms of your body. The signals measured during this method need to be converted into visual information and are seen on the computer in the form of two- or three-dimensional images of bones, soft tissues and joints.
MRI scans are helpful for examining soft tissues like ligaments, muscles or cartilage as these tissues have lots of water.
MRI examinations are used for things like shoulder, spine or knee problems. MRI imaging may show ligament, signs of wear and tear, bone inflammation and meniscus injuries.
An MRI scanner is a tunnel-like device with special coils that produces radio waves and magnetic fields. You will have to lie down on the table for the examination which is then moved into the machine, depending on the part of the body being examined. While images are taken, you can hear loud tapping noises. An MRI examination may require nearly 15 to 30 minutes in total.
Individuals who have undergone implants and have been affected by magnetic fields like pacemakers cannot go for MRI scans. These days, some hospitals and practices have open MRI scanners that can be helpful for the ones who are afraid of being in a restricted space or who are overweight.
Bone density tests, also called bone densitometry or osteodensitometry measures the amount of minerals present in the bones. The result tells how resistant the bones are to fractures. Bone density is measured with a special x-ray technique known as dual energy x-ray absorptiometry (DXA or DEXA). Weak x-rays are usually sent through the top of the thigh bone and bones of the spine.
If someone has wear and tear in the spine, this method will be used to look at the thigh bone. On the other hand, if someone has an artificial hip joint, it is used to look at their spine only. People who have undergone DXA are exposed to less radiation than conventional x-ray examination and less radiation than computed tomography.
Bone density tests don’t show x-ray images, rather, they measure how x-rays can pass through the bones. The more porous and brittle the bones may be, the more x-rays can pass through them. The x-rays that pass through the bones can be expressed in a measurement known as T-score. This T-scoremeasures and compares your bone density with the bone density of young and healthy adults.
At times, computed tomography (CT) or ultrasound examinations may be used to measure bone density of the heel. However, there isn’t proper research whether these measurements are more or less reliable than the obtained ones with DXA.
Bone densitometry may be used to know if someone has osteoporosis and how high their risk of bone fractures might be. It can be used to evaluate the effects of the treatment.
You will have to lie flat on the back for your DXA scan. If the density of the bones in your spine is measured, then your legs will be raised and bent at a 90° angle. Your legs will lie flat for measuring the neck of the femur.
A generator below examination table produces x-rays while a scanner moves above the body to calculate how much radiation was absorbed by your body. The examination usually takes 5 to 10 minutes.
Bone scans or bone scintigraphy produces images of the bone’s metabolism. If you want to get a clear image, a weak radioactive substance will be injected into the body before your examination. This substance will accumulate in the bones thus, making it easy to see the different bone structures. Certain things like inflamed tissue or cancer metastases often store more of this substance than healthy tissue. Bone scans may involve direct exposure to radiation.
Bone metabolism might change if there is bone inflammation or a tumor is growing in the bone. Bone scans can be used if someone suffers from any of these problems and they may be used to look at poorly-healing fractures.
The doctor injects radioactive substance into the vein to prepare the patient for the examination. It usually requires a few hours for this substance to spread throughout the body. You need to lie down and a special camera will take images when it moves over the body.
For bone biopsies, the doctor takes tissue out of the bone with a thin needle to test for certain disease changes. In bone marrow biopsies, the tissue is not taken from the bone itself rather from bone marrow inside the bone.
Bone biopsies may be done to examine things like inflammations, tumors and bone structure problems like osteoporosis. Bone marrow biopsies might be considered for people who have a problem with blood production like anemia.
Once the skin above the bone is anesthetised, a small cut will be made to insert the biopsy needle. In bone biopsies, the tissue is often taken from the pelvic bone,however, it can also be taken from the femur (thigh bone) or patella (kneecap). In bone marrow biopsies, the sample will be taken from the breastbone or from the upper part of the pelvic bone (the iliac crest). The sample will then be tested in the laboratory.
Blood tests are used to diagnose certain bone related diseases. One such example is osteoporosis in which you need to book a blood test to determine the risk factors and rule out other diseases. For instance, blood calcium levels may be measured to know if someone is getting enough calcium, but this does not provide information about how much calcium is present in the bones. Another blood parameter is “alkaline phosphatase,” which is a protein that increases if someone has bone diseases.
Other blood parameters can be used to detect tumors, signs of inflammations or metabolic diseases that may affect the overall condition of the bones.
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