Musculoskeletal Experience and Specialization

Imaging Joint Disorders and Cartilage, Including Lateral Knee, Shoulder, Hip and Back Pain and Bone Density Tests

Cartilage Imaging - UCSF Medical

Our musculoskeletal section is a worldwide leader in imaging joint disorders and cartilage, and we use highly sophisticated techniques to analyze cartilage quality (T2 and T1rho relaxation time), which allows us to determine which patients may be at higher risk to develop osteoarthritis. We now can also achieve pain relief in patients with osteoarthritis by injection of lubricating substances that can cushion osteoarthritic joints and delay the implantation of total joint replacements. We also inject pain medication and steroids, which provide immediate pain relief. 

MRI of the Upper Extremity: Shoulder, Elbow, Wrist and Hand

Dr. Lynne Steinbach is a co-editor (along with Dr. Christine Chung from UC San Diego) of the highly acclaimed text “MRI of the Upper Extremity” from Wolters Kluwer/Lippincott Williams & Wilkins publishers. This book is a culmination of the musculoskeletal imaging section's experience with MRI of the various regions of the upper extremity. We work with an excellent sports medicine team that  sees patients with a lot of different upper extremity problems, providing constant feedback to our cases, allowing us to become even more expert in the field. This highly illustrated text/atlas is a complete guide to MRI evaluation of shoulder, elbow, wrist, hand, and finger disorders. The editors present a practical approach to MRI interpretation, emphasizing the clinical correlations of imaging findings. More than 1,100 MRI scans show normal anatomy and pathologic findings, and a full-color cadaveric atlas familiarizes readers with anatomic structures seen on MR images. Coverage of each joint begins with a review of MRI anatomy with cadaveric correlation and proceeds to technical MR imaging considerations and clinical assessment. Subsequent chapters thoroughly describe and illustrate MRI findings for specific disorders, including rotator cuff disease, nerve entrapment syndromes, osteochondral bodies, and triangular fibrocartilage disorders.

Our departmental expertise includes the use of high field high resolution MRI to analyze the spine, bones and joints to address, for example, lateral knee pain or hip and back pain.  We were one of the first sites in the country to use 3T MRI for the imaging of joints and to develop the protocols for that imaging which can provide insights into the cause of knee pain as well as hip and back pain. In our new UCSF Orthopaedic Institute, we recently installed the latest generation 3T MRI scanner, which has the sophisticated sequences and protocols for joint imaging. The musculoskeletal section also leads the way in testing protocols and methods for bone density. Our specialists conduct advanced bone density tests to investigate potential or existing bone deterioration and increased fracture risk.

Cartilage Imaging Book - UCSF Medical

Cartilage Imaging

Dr. Thomas Link has developed a volume with experts who provide their insights and advanced practices regarding cartilage damage, diagnosis, and repair.  Major advances in cartilage imaging are put into clinical context relevant for radiologists, rheumatologists, and orthopaedic surgeons and the important role of MRI in cartilage imaging is explained.  The result is an authoritative book that provides the most advanced practices and new developments in the imaging of cartilage, associated pathologies, and repair procedures.

 

 

Adult and Pediatric Bone Density Tests

Bone Density Test - UCSF MedicalOur special expertise in adult and pediatric musculoskeletal (MSK) imaging includes DXA (Dual energy X-ray Absorptiometry) and CT bone densitometry. The reputation of the MSK section in bone densitometry has grown over the past 30 years, when Dr. Harry Genant, former Chief of MSK Radiology at UCSF, pioneered the use of CT for bone density tests.  Dr. Genant founded the Osteoporosis and Arthritis Research Group in the Department of Radiology at UCSF in 1986, which has been widely acclaimed as a leading source of research in noninvasive imaging methods applied to osteoporosis, arthritis and orthopaedics.  Over the years the MSK radiology section at UCSF has become a leading institution for developing and establishing diagnostic techniques in osteoporosis.

Today, this tradition continues, as we provide the most advanced techniques in osteoporosis imaging available.  (Read more about our legacy and early musculoskeletal radiologist, Howard Steinbach, MD)

 

Metal Suppression

Metal Suppression MRI - UCSF Medical

For those patients with total joint replacements and other metal implants who are experiencing  pain of the joints such as the knee, hip and shoulder, our 3T scanner has sequences to suppress metal artifacts, which allows us to thoroughly investigate joints. These advanced imaging techniques are available in only a few other leading institutions in the USA, including the Mayo Clinic and the Hospital for Special Surgery in New York.

Interventional MSK Procedures - UCSF Medical

Interventional MSK Procedures

The musculoskeletal section at UCSF also performs interventional procedures, including CT-guided bone and soft tissue biopsies as well as radiofrequency ablations of osteoid osteomas and other tumors. We are one of the premier sites on the West Coast to perform these procedures, and osteoid osteoma patients come from throughout the United States for treatment at UCSF.  In fact, the youngest patient ever to receive radiofrequency ablation for the treatment of osteoid osteoma came to UCSF to be treated by Thomas M. Link, MD, PhD. Dr. Link, who joined the staff at UCSF in 2003, has 20 years of special expertise in imaging and interventional procedures for bone tumors.

MSK Technologists - UCSF Medical

Dedicated Musculoskeletal Technologists

We have dedicated technologists who have years of expertise with imaging of bones, joints and soft tissues. Our UCSF musculoskeletal technologists are a fundamental part of the musculoskeletal imaging team. This provides a direct benefit for our patients experiencing pain of the joints or the back, or for those requiring bone density testing.

Collaborative Approach

Within the musculoskeletal subspecialty at UCSF, we foster close collaboration with the physicians who refer to us, including experts in Orthopaedic Surgery, Rheumatology, Oncology, Primary Care and Internal Medicine. We are proud of the solid relationships we have developed with physicians in the greater community beyond UCSF as well as with physicians at UCSF.

 

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