In this section, the primary modalities include radiography, CT, MRI, and some ultrasound. In general, each modality is useful for answering particular clinical questions. Radiography is a low-cost, easily available way of evaluating bones for fractures and other disease processes (arthritis, avascular necrosis, tumor). Not all fractures are radiographically apparent, however, and MRI and CT are both more sensitive. MRI is also very sensitive for osteomyelitis as well as other processes involving the bone marrow. It is also particularly useful for evaluating intra-articular (ligaments, cartilage) and extra-articular (tendons) soft tissue structures. Ultrasound may be used to evaluate for diseases of extra-articular soft tissues and, along with fluoroscopy, is also used for guiding certain procedures. Common disease processes evaluated in this section include trauma, arthritis (degenerative and rheumatologic), osseous tumors, sports injuries, and congenital as well as metabolic bone disorders.
The MSK reading room is located on the first floor in the Nesson Ambulatory Care Center (see BWH Pike map).
In addition to plenty of radiographs, during your time in this section, you should also attempt to observe at least one arthrogram and at least one image-guided biopsy (if any are scheduled) as well as the interpretation of at least one joint MRI. Arthrograms occur in Room 8 just next to the reading room, while biopsies occur on L1 across from the Abdomen CT/MRI reading room (again, ask the fellow to review the clinical history, imaging, and indication for the procedure ahead of time). See above for the layout of the MSK reading room.