ortho diagnostic tests
What are some things to discuss with a patient before an MRI
MRI can make people feel claustrophobic, No metal is allowed, if contrast is used ask about kidney function and contrast allergies
arthrography
less expensive than CT or MRI, radiopaque contrast or air is injected into the joint cavity to evaluate joint structures. The joint is put through ROM to distribute the contrast while a series of X-rays are taken.
dual energy x-ray absorptiometry (DEXA)
Looks at bone mineral density and determines risk of fracture for a patient with osteoporosis (It may look at bones of spine, hip, and wrist)
what are the indications of arthrocentesis?
to relieve pain from fluid build up in the joint, and to get a sample of synovial fluid
CT Scan
used to visualize and assess tumors and injury to soft tissues, ligaments and tendons. It is also used to identify the location and extent of fractures that are difficult to evaluate and not visible on x-ray. (Can be done with or without contrast.)
electromyography
detects electrical potential of muscle after nerve damage. determines abnormality of function, differentiates between muscle and nerve problems
bone densitometry
estimates bone mineral density and is used to estimate the extent of osteoporosis and monitor how well osteoporosis treatment is working
indications of electromyography
evaluates weak muscles, pain and disability
Osteomyelitis
inflammation of bone and bone marrow
Nursing interventions with a bone scan
assess client for allergies to the isotope, explain to the client that they may feel a warm or flushing feeling for a brief period after the injection. Encourage fluid intake to help distribute the isotope
What do you need to assess for with a CT scan?
kidney function and allergy to contrast
x-ray
looks at bone density, texture, erosion, signs or irregularity, presence of fluid, narrowing of the joint, spur formation, and changes in the joint structure, may require multiple x rays with multiple views (anterior, posterior, lateral)
arthroscopy
looks directly at a joint through an endoscope to diagnose disorder. Used for surgical repair for tears of tendons.
what does a arthrography look for?
looks for tears in the joint, the joint capsule (the envelope surrounding the joint), the ligament and looks at the surface integrity of a joint
Bone Scan
may find things that aren't yet detectable on x-ray. detects bone tumors/cancer, osteomyelitis, and aseptic necrosis (which is poor blood supply that causes necrosis of bone)
arthrocentesis
needle aspiration used for joint aspiration of synovial fluid related to pain due to effusion. Performed using aseptic technique. Sterile dressing is applied after aspiration.
how an electromyography is done
needle electrodes are inserted into selected muscles and responses to electrical stimuli are recorded on an oscilloscope
MRI
reveals injury to tissues, muscles, ligaments, and cartilage. May be used for pre-operative planning, detecting tumors, as well as cartilage, tendon and muscle abnormalities. Can determine extent of injury or disease. (can be used with or without contrast)
what happens in a bone scan?
Radioisotope is injected through an intravenous (IV) line and the scan is performed two to three hours later because the isotope needs time to absorb into bone, test looks at how much isotope is absorbed in bones, images are taken
Oscilloscope
A piece of test equipment used to view and measure a variety of different waveforms.
What should the nurse do for the patient who has had an arthroscopy?
Compression dressings applied after procedure. Apply ice and elevate extremity. Frequent neuro checks
lab studies assessed for bone abnormalities
WBCs, coagulation studies, serum calcium, phosphorus, acid phosphatase, alkaline phosphatase, creatine kinase (released when there is damage to skeletal muscles), calcitonin, parathyroid hormone, and vitamin D levels
bone biopsy
With these samples the lab can look at the structure and composition of bone marrow, bone, muscle, and synovium to diagnose disease