: Rajiv R. Shah, MD
Musculoskeletal Radiology involves the imaging evaluation of bones, joints, muscles, tendons, and ligamentous structures of the body. Due to the integral nature of the Emergency Department (ED) and Trauma Surgery at MetroHealth Medical Center, a substantial portion of our Radiology Department services are diagnostic investigations and therapeutic procedures for trauma and emergency patients. The pathologic entities encountered include traumatic musculoskeletal injuries; sports injuries; benign and malignant bone and soft tissue neoplasms; metabolic bone diseases; arthritis; congenital/developmental lesions; and bone and soft tissue infections.
Virtually all imaging modalities are utilized in Musculoskeletal Radiology, including plain radiographs, computed tomography (CT), including newer 256 row detector CT, ultrasound, nuclear medicine, and magnetic resonance imaging (MRI) studies. Currently we are performing magnetic resonance arthrography (MRA) for evaluation of the complex anatomy of the shoulder, wrist, and elbow. State-of-the-art MR imaging is performed of the musculoskeletal system with the latest pulse sequences. This service continues to grow especially in the field of musculoskeletal MRI due to ever changing protocols and techniques.
MetroHealth Medical Center operates a Critical Care Pavilion, which contains a state-of-the-art Emergency Department and operating suites.
Musculoskeletal Radiology was organized to provide a more effective integration of clinical services, teaching and research efforts, and improve serves to our referring physicians. This section works most closely with the Orthopaedic Department, the Emergency Department, and the Division of Trauma Surgery within the Department of Surgery. Most of the daily activity within the Musculoskeletal Radiology section takes place within the Emergency Department Radiology Suite, where radiologists work closely with ED, orthopaedic, and trauma physicians to quickly diagnose major traumatic injuries in Metro Life Flight patients and others. After initial radiographic evaluation, a patient may undergo high resolution CT scans of injuries, often using state-of-the-art 3-D surface and multiplanar reconstructions of the data to optimally delineate injuries preoperatively. High resolution MRI studies are also used to reveal soft tissue injuries in trauma and sports medicine patients, including meniscal and ligamentous injuries of the knee, and rotator cuff injures of the shoulders. Other diagnostic and therapeutic procedures, such as traditional arthrographic studies of the joins, breath-hold imaging for evaluation of abdominal organs, gadolidium magnetic resonance arthrography, joint injections with anesthetic agents or steroids, and other image guided biopsy procedures are performed as part of the Musculoskeletal Radiology services.
Musculoskeletal Radiology is an integral portion of the radiology residency curriculum. The service is intensively involved with teaching or residents, medical students, and rotating physicians. Didactic lectures, case conferences, and teaching during film interpretation sessions give the radiology residents a firm foundation in musculoskeletal radiology. Participation in regular Trauma and Orthopaedic interdepartmental conferences also aid in the education of residents from other disciplines.