Diagnostic Imaging for foot and ankle problems
Different diagnostic imaging exams that can be performed or ordered by a podiatrist.
X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. Standard X-rays are performed for many reasons, including diagnosing tumors or bone injuries. Podiatry uses X-rays to help determine many foot ailments. Most foot X-rays must be weight-bearing to determine how the foot and bones of the foot move in relation to the ankle and leg. Weight-bearing views MUST be used prior to any bunion surgery or foot reconstruction procedure. Such problems could include: fractures, tumors, bunions, hammertoes, bunionettes, stress fractures, edema, pediatric flatfoot, adult flatfoot, and many more.
Clinical evidence and research supports using ultrasound as the first diagnostic test for numerous musculoskeletal (MSK) conditions. Diagnostic ultrasound offers a number of important advantages compared to computed tomography (CT) and magnetic resonance imaging (MRI), in terms of safety and effectiveness. Diagnostic ultrasound is noninvasive and offers real-time imaging, allowing for examinations of structures at rest and in motion. This ability to capture the movement of musculoskeletal components differentiates it from other imaging modalities and can permit more accurate diagnoses. Other advantages for your patient include its portability, which allows for point-of-care application and interpretation. Dr. Dennis Timko of Arch City Foot & Ankle uses military used ultrasound called Sonosite. You can also see this video from Sonosite that shows how a podiatrist can use ultrasound to allow for precise injections into foot or ankle joints.
MRI is short for Magnetic Resonance Imaging. It is a procedure used in hospitals and outpatient offices to scan patients foot and ankle to determine the severity of certain injuries. An MRI machine uses a magnetic field and radio waves to create detailed images of the body. Common reasons people go in to get an M.R.I. are tumors, stress fractures, tendon injuries, muscles strains, ligament damage, etc. This expensive exam is used extensively in professional athletes to diagnose the injury quickly and to evaluate for healing.
Computed tomography (CT) examination (also known as a CAT scan)
Computed tomography (CT) is a special type of x-ray exam that produces detailed pictures of structures inside the foot or ankle. CT uses a narrow x-ray beam that is directed through the foot and ankle and recorded by sensitive detectors. This information is analyzed by a computer to produce a cross-section picture or “slice” of the area being studied. Most podiatrist must send a patient to a hopital or outpatient location for the test but there are in office CTs that are expensive but available.
Vascular arterial studies are considered third-party reimbursable when performed using a bidirectional Dopplers that produces a hard-copy output. Dr. Dennis Timko uses Koven Technology, which distributes many types of non-invasive vascular Dopplers to help podiatrists properly diagnose PVD or PAD (peripheral arterial disease).
This includes Epidermal Nerve Fiber Density Testing as well as skin and toenail biopsies for many different types of skin and foot diseases. This test is used to exam and quantify small nerve fiber disease in the foot and lower extremity. It is a excellent test that detect diabetic neuropathy at its earliest stage. That way a doctor can begin treatments including educating patients to take certain vitamins, before the neuropathy becomes irreversible.
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