Musculoskeletal Imaging in Northern California Bay Area

Founded in 1982, California Advanced Imaging Medical Associates, Inc. has grown to 60 radiologists who provide subspecialty expertise at 10 hospitals and multiple outpatient imaging centers in the San Francisco Bay Area as well as nationally through its subspecialty teleradiology practice.

CAIMA’s mission is to work with our hospital partners and outpatient centers to serve our communities and to provide state-of-the-art, accurate, comprehensive, and compassionate musculoskeletal imaging services to our patients.

Musculoskeletal Imaging is an area of radiology that provides diagnostic imaging examinations of the skeleton, ligaments, muscles and joints. Specifically, musculoskeletal imaging is used to diagnose conditions that include arthritis, sports injuries, trauma and tumors. Procedures vary from general x-ray examinations to more complex ones such as joint aspiration, arthrography, biopsies, and stereotactic injections.

MRI Examinations

MRI examinations (magnetic resonance imaging or scanning) are used in musculoskeletal examinations because of their particular value and usefulness in imaging and evaluating soft tissue structures such as cartilage, muscles, bone marrow, nerves and vascular structures.

MRI Arthrography

MRI Arthrography is a two-step examination, an arthrogram and an MRI exam. It is performed because of its exceptional diagnostic accuracy when there is a need to examine large joints like the shoulder, knee and hip and small joints such as the ankle, elbow, and wrist. It is also used for complex cases such as postoperative knee and postoperative shoulder evaluations. Prior to the MRI exam, an arthrogram is performed in which a contrast agent (dye) is injected into a joint using x-ray fluoroscopy for guidance. The dye allows better visualization of the joint and possible tears of tendons or cartilage on the images produced by the MRI exam.

After the dye has been absorbed into the joint, the MRI exam is performed. The MRI generates different views of the joint and together with the dye, produces highly detailed images with extremely accurate information for a diagnosis or evaluation.

Computed Tomography (CT scan)

Computed Tomography or CT scanning examinations are used in musculoskeletal examinations because of their value and usefulness in examining and evaluating bony areas for fractures, healing processes, bony alignment, infections, and bone tumors. It is also particularly helpful in providing multiple views and three-dimensional image reconstructions that can be helpful in surgical planning. To help visualize the vascularity of the structures being examined, a contrast agent or dye may be administered.

CT Arthrography

Similar to MRI arthrography, CT arthrography is also a two-step examination, an arthrogram and a CT examination. It is used because of its ability to produce finely detailed images of the bony areas noted above. Prior to the CT examination, an arthrogram is performed in which a contrast agent (dye) is injected into the joint using x-ray fluoroscopy for guidance. Occasionally a radiologist may elect to do a double contrast exam and inject air along with the dye. The dye allows better visualization of the areas being examined on the images that will be produced by the CT exam.

After the dye has been absorbed, the CT exam is performed. The exam generates different views of the bony structures and together with the dye, produces highly detailed images with accurate information for an evaluation or diagnosis.

CT Guided Bone Biopsy

CT guided Bone biopsies are conducted to obtain tissue samples from bone or surrounding tissue for histological diagnosis. By employing the use of a CT scanner to produce images from different angles or views (stereotactic imaging), the radiologist is able to localize the area on the patient and perform the biopsy with extreme precision.

Joint Aspiration

Large joints like the shoulder, hip and knee contain synovial tissue that produces a lubricant like fluid. Joint aspiration is performed when there is a need to remove this fluid to determine the causes of swelling, arthritis, gout and rheumatoid disease. Using fluoroscopy for guidance, a needle is placed into the joint and the fluid is aspirated (withdrawn). The fluid is then sent to a laboratory for analysis.