Arthrogram: a procedure performed by injecting contrast into a joint, then imaging the joint. The radiologist performs the study utilizing CT imaging to accurately guide the needle into the joint and then injects an appropriate amount of contrast. Contrast is a liquid solution that shows up on images. In instances where there is a tear the liquid (contrast) leaks out of the “normal” area.

Contraindications: patients allergic to or sensitive to medications, contrast dyes, local anesthesia, iodine, and latex.

Portal Gravity: for Lumbar and thoracic spine imaging, we have recently added the FDA approved Portal Gravity weight bearing simulation device. There are a total of 43 centers in the country using this technology, but we are the only center in Missouri utilizing this state–of–the–art equipment.  ([expand title=”show more)” swaptitle=”show less)” notitle=”true” rel=”procedure-highlander”]

The portal gravity system is an accessory for axial compression of the spinal column in and MRI for enhanced and more relevant diagnosis during research and clinical purposes. This device simulates weight bearing with the patient in a supine, recumbent position by placing a vest on the patient that has been loaded with a variable amount of downward tension. The tension is pulled toward the patient’s feet, simulating the weight held by the spine while the patient is upright. This allows for diagnosis of annular tears and herniated discs that are otherwise not visible when the patient is non–weight bearing. In some cases lumbar disc herniations are not visible on non–weight bearing studies, but are visible on these simulated weight bearing views. This process allows for a quicker, more thorough diagnosis, with faster treatment and recovery of the patient.

Indications for use of Portal Gravity System:

The Portal Gravity System is an accessory for axial compression of the spinal column in diagnostic imaging equipment for enhanced and more relevant diagnosis research and clinical purposes.

Contraindications/Exclusion criteria of Portal Gravity System:

• Severe osteoporosis
• Tumors of any kind (especially spine)
• Acute vertebral trauma
• Cardiopulmonary disease
• Severe osteoporosis
• Trauma/Abuse
• Acute shoulder injuries
• Myofascia syndrome

Our technologists have been trained in the proper use and function of the Portal Gravity System. This training was provided by David Carter Director of Operations, Portal, Inc. at Portal Medical of North Logan, Utah.[/expand]

Ankle Tenogram: injection technique to relieve chronic ankle pain.   ([expand title=”show more)” swaptitle=”show less)” notitle=”true” rel=”procedure-highlander”]

Ankle tenography is primarily a diagnostic technique to aid in diagnosing chronic ankle pain, referable to the tendons, that has been unresponsive to more conservative therapy (i.e., immobilization, bracing and physical therapy). These can be accompanied with injection as a combination of local anesthetic and steroid. This has been shown to be useful in localizing pain and in surgical decision making.

Warning Signs:

• Pain and tenderness along a tendon, usually in proximity to the ankle or foot
• Pain is worse with movement or activity
• Pain at night
• Tenderness and swelling over the area where the tendons insert onto the ankle or foot
• Pain when your try to bend the ankle or foot
• Stiffness after exercise

Tendonitis: tendonitis literally means inflammation of the tendon. Tendons can become inflamed for a variety of reasons, and movement of the tendon becomes painful and limited. If the normal smooth gliding motion of your tendon is impaired, the tendon will become inflamed and movement will become painful. This can occur in any tendon of the body, but in the ankle tenosynovitis most frequently occurs in the posterior tibial tendon and in the two peroneal tendons.

Peroneal Tendonitis: an inflammatory condition of the peroneal tendon, which runs along the outside of the lower leg. behind the ankle and under the foot. This condition is commonly seen in runners as an overuse condition. It can also occur as a result of injury, overuse, or with aging as the tendon loses elasticity.

Posterior tibial Tendonitis: a strain placed on the posterior tibial tendon, a tendon located on the inside part of the ankle just behind the bony knob. This tendon is responsible for raising the arch of the foot. This tendonitis can occur as a result of injury, overuse, or with aging as the tendon loses elasticity.[/expand]