Anchor: Welcome back to We Are Austin. When you have an accident, for instance, perhaps a scooter crash, and doctors suspect a trauma injury, ARA Musculoskeletal Radiologists go to work to find out exactly what’s wrong. We are joined this morning by Dr. Jeff Wood who’s going to share more about the tools and imaging that you guys use to diagnose injuries and bone disease, which is really important. Good morning to you! Thanks for being here!

Doctor: Good morning, nice to see you again.

Anchor: So, this is kind of an important chat. You’ve really got to figure out what’s wrong and you’ve got a really great toolbox to use. How do you do that?

Doctor: It’s true. Welcome.

Anchor: Oh yeah, there we go.

Doctor: Scooter for one.

Anchor: This. Trevor did that. Yep.

Doctor: So, I tried to set this up a little bit like a handyman.

Anchor: Yeah.

Doctor: We have this arsenal of imaging, sort of like a toolbox.

Anchor: OK.

Doctor: We have really simple things like X-ray, sort of like a hammer or a screwdriver, something that everybody has, everyone uses all the time.

Anchor: Yeah.

Doctor: And then some of these, a little bit more specialty type–imaging modalities is what we call them–are other tools.

Anchor: Excellent. OK. So, you have a lot of options is what you’re saying?

Doctor: Absolutely!

Anchor: Excellent.

Doctor: Today’s day and age, I figured we had to have emojis. Right?

Anchor: Doc, I love this! This is a great idea! You’ve designed to kind of explain how these are all used.

Doctor: Yeah, hopefully so. So, radiation, like Chernobyl, right?

Anchor: Yeah.

Doctor: The more or less that we use – some imaging uses none, some uses a fair amount. It’s still all very low in relation to health safety.

Anchor: OK.

Doctor: But, you’ll see this, to quantify a little bit of what we’re using.

Anchor: Very cool.

Doctor: Strengths – what the actual imaging tool is good at, whether that be bone or sort of soft tissue, what we call muscles, tendons, those sorts of things.

Anchor: Excellent. So depending upon what you’re really looking for is how you will choose some of these options.

Doctor: Yeah.

Anchor: Very cool, OK.

Doctor: Obviously X-ray – that’s the one that everyone’s seen, heard. Probably everyone’s had at some point in their life. Whether you’re hooking ‘em, right? Or, you have a finger dislocation.

Anchor: Ouch!

Doctor: Like Curry had, or you fell off your scooter.

Anchor: Hey.

Doctor: Or you had a car wreck, motorcycle.

Anchor: Mmm. OK.

Doctor: So, radiation, a little bit, not much; but that’s the way that we get this picture to happen.

Anchor: Excellent.

Doctor: Its main strength is bone, as you can see, and then the soft tissue. See how they start to blend in. It’s very difficult to, to really see what’s going on with that.

Anchor: Excellent, but still used to this day.

Doctor: Every day. That’s the best starting point. We need that in almost any injury that we have. Whether we end up going down the road to some of these other things.

Anchor: Very cool. All right. And CT, we hear this a lot.

Doctor: Yeah, so CT is another one that is good for lots of things including musculoskeletal or sports things. We use it mainly for bad trauma for pre-operative evaluation.

Anchor: OK.

Doctor: Another, again, another strength is bone.

Anchor: OK.

Doctor: But this is actually just a compilation of a whole bunch of X-rays that then the computer genius puts together and we can then do many different things. And because of that, it actually has more radiation.

Anchor: A little more radiation.

Doctor: Because it’s a whole bunch of X-rays put together.

Anchor: Interesting. Very cool.

Doctor: So, one of the cool things that we use it for often is pre-operative evaluation. So, this is the leg bone or the femur where they snapped it. We can use this before the orthopedic surgeons go in and we can get the right size of plate and screw.

Anchor: Wow!

Doctor: Or, what hardware they’re going to get.

Anchor: Fascinating. Great imaging there. Yeah.

Doctor: Yeah. Fluoroscopy is another one you may hear. That’s actually video X-ray.

Anchor: OK.

Doctor: So, I can use that live while I’m doing injections. A quick example here is actually an arthrogram. So, I have a needle in the shoulder joint and then you can see this little bit of bright stuff. We actually put contrast in and then when we use some of these other imaging modalities subsequently, you can see what’s going on on the inside better because you’ve blown up the joint.

Anchor: Very cool! That’s an interesting one, I haven’t heard it.

Doctor: So, very little, very little radiation.

Anchor: Little bit. OK.

Doctor: But really good for bone and again, it’s really just an X-ray.

Anchor: Yeah.

Doctor: And so the soft tissues aren’t very good.

Anchor: Very cool. All right.

Doctor: So, then sort of our biggest power tool, you know, the thing that not everyone is in need of, but often times we end up having to go to especially for sports injuries, muscles, tendons, ligaments.

Anchor: OK.

Doctor: Is the MRI.

Anchor: MRI. Yeah.

Doctor: So, one big thing is it doesn’t have radiation.

Anchor: OK.

Doctor: But it costs more, takes more time, and so it’s not something we always need.

Anchor: I see.

Doctor: So, you know, a couple of real common examples, this was actually that shoulder arthrogram that I had the needle in on the fluoro.

Anchor: Interesting. OK.

Doctor: So, this bright stuff is the contrast and we blew it up, and why we did that is so you can see this labral tear.

Anchor: Right there. That’s fascinating.

Doctor: So, a very common thing you’ll hear about pictures and those sorts of things.
And then, you know, the most common sports injury that most people hear about is an ACL.

Anchor: That’s right.

Doctor: This should be a nice dark line and it’s gone.

Anchor: It is not but you can see that thanks to this technology. Very cool.

Doctor: And one of our last ones that we use pretty commonly especially in sports intervention, is ultrasound. So again, another modality that doesn’t have radiation. So, it’s really, really good for portability. Now a lot of them are coming almost in a briefcase size.

Anchor: Right. Yeah.

Doctor: So, this is one of the first things we can take out into the field, have at arenas, that sort of thing. It’s not good for bone. Sound waves don’t go through bone but it’s very, very good for muscles. So, this is something that I use often, for my procedures because I can actually watch the needle live as its going to where I’d like it to be.

Anchor: Yeah, and that mobile modality is really, really special too. This is important, especially because when people are at the doctor, you’re already out of your element and nobody likes being talked at. This is a really educational opportunity. Heaven forbid you find yourself at the point of an injury. This is great information for them to take with them. This is what you do at ARA. If people want to know a little bit more, where can we go for more information?

Doctor: We go right here at ARA. Google it. I think we have the number up there on the screen.

Anchor: You got it right there.

Doctor: We’re pretty much all over the city.

Anchor: You guys are excellent man and you do a great job of really making this accessible.
Doctor, thank you for being here.

Doctor: It’s good to see you guys.

Anchor: It’s a very educational segment.

Doctor: Absolutely.

Anchor: We appreciate it man.