Workup

Bone and joint pain

What are the common causes for bone or joint pain?

• Trauma
• Arthritis
• Neoplasm
• Infection
• Degenerative Joint Disease

Which is the imaging procedure of choice in a patient with bone or joint pain?

Working diagnosis based on history and physical will dictate which imaging procedure should be ordered.

• Plain radiograph is the imaging procedure of choice in trauma and arthritis.
• CT should be considered when there is soft tissue and joint injury.
• MRI is useful for the evaluation of primary bone neoplasms, location and extension of disease.
• MRI is also useful for detecting fractures when plain film do not demonstrate the fracture.

What is the imaging procedure of choice in patients with trauma?

• Plain x-rays first
• CT or MRI of the area if unresolved
• Bone scan will show increased isoptope at the site of fracture and is sensitive but is delayed untill osteoblastic activity is initiated.