Feb 27 2005
New imaging technologies are enabling doctors to not only diagnose a variety of orthopaedic and musculoskeletal conditions with more accuracy, but also to determine with unprecedented precision whether clinical recovery from bone, joint or tendon damage is actually complete and not simply a "placebo effect."
Radiologists examining patients with damaged tissue are increasingly using ultrasound and specialized MRI techniques that allow examination with great detail - to provide non-invasive diagnostic tools that replace the need for routine arthroscopic inspection.
"New imaging technology may serve as objective outcome measures for orthopedic conditions, both at initial diagnosis as well as following pharmaceutical or surgical intervention," said Hollis G. Potter, MD, Chief of Magnetic Resonance Imaging (MRI) at the Hospital for Special Surgery in New York City.
Dr. Potter's remarks were part of a keynote address, "The Future of Orthopaedics: Advancements That Will Affect How Care is Provided," which she presented on Thursday, Feb. 24 at the annual meeting of American Academy of Orthopaedic Surgeons (AAOS) in Washington, D.C.
"Doctors treating patients for orthopaedic problems often witness a placebo effect. It's not surprising because people want to feel better, especially when orthopedic problems are hindering their daily activities," said Dr. Potter. "With time and after treatment, patients may feel better, but sometimes the underlying biology for that patient's problem tells a very different story."
Dr. Potter said that observable clinical outcomes such as walking and stair climbing ability are still important measures for patients who have sustained joint or tendon injury, have severe arthritis or undergone joint replacement surgery.
She added that imaging technology "should be held to the same degree of rigor as any clinical outcome instrument, and should be validated with regards to accuracy and reproducibility."
"In osteoarthritis, new imaging techniques permit early disease detection, serve as an objective outcome measure for cartilage repair procedures and also provide a measure by which to assess disease modification with pharmaceutical intervention," Dr. Potter said.
"At the end of the clinical spectrum of osteoarthritis (arthroplasty), new imaging techniques allow for more sensitive and earlier detection of particle disease, with non-invasive and more precise quantification of bone loss, as well as detection of synovial reaction at the origin of the adverse biologic reaction," Dr. Potter said.
The Hospital for Special Surgery offers one of the largest and most experienced team of musculoskeletal radiologists in the world.