Understanding Musculoskeletal Imaging Uses and Methods

muscloskeletal imagingMusculoskeletal imaging is a specialty used to look at disorders of the joints, bones and soft tissues associated with their connections. These images can be done on both adult and pediatric patients depending on individual health concerns.

This type of imaging is used in a variety of health explorations including:

  • trauma situations
  • sports medicine (e.g. forceful impacts or repeated strains)
  • work related disorders caused by repeated motions and vibrations
  • bone and soft tissue tumors
  • joint disorders such as certain types of arthritis
  • tears in tendons or ligaments (i.e. knee, shoulder and hip)
  • congenital malformations of extremities in infants and children
  • swelling or bleeding of tissues around joints

During your first appointment with your medical provider, you can expect a physical examination that will involve inspection, palpation and manipulation of the affected area. First they will look for redness, inflammation and other visible signs of an abnormal occurrence. Next they will touch the area and exert some pressure to see how the body responds to an external stimuli. Finally they will perform a range of motions to see how the area reacts to different types of movement. All of these together will help them to determine what kind of musculoskeletal condition they need to consider.

If your doctor determines that imaging would be necessary to see details of your condition, a number of different imaging options can be used:

  1. X-rays – this basic imaging is usually a start to get a first look at the bones, joints and soft tissue to form an initial assessment.
  2. MRI (magnetic resonance imaging) – using a large magnet an MRI can produce a detailed look at the structures of the musculoskeletal system giving anatomic detail and even can provide detailed information of bone marrow in cases of infection or tumor.
  3. CT (computed tomography) – these images allow for a production of a three-dimensional view, making them useful in the evaluation of bone architecture, fractures and orthopedic hardware.
  4. Fluoroscopy – is a type of X-ray that creates moving images of joints as they are functioning.
  5. Ultrasound – using sound waves, an ultrasound can produce images of muscles, joints, tendons and ligaments in a noninvasive manner.

Musculoskeletal imaging also assists with soft tissue biopsies when using CT guidance or ultrasonographic procedures.
All of these imaging options have strengths for different diagnosis results and your doctor will help to determine the best course of labs for your individual circumstances.

Peninsula Radiology Associates is a full service imaging provider serving the entire Peninsula.  Our specialists are trained in the latest techniques so that you can have confidence you’re receiving an accurate imaging diagnosis.  Contact us at (757) 989-8830 for an appointment.  We are happy to serve your imaging needs!


Ultrasound Facts For Your Consideration

ultrasound factsMany people associate an ultrasound scan with pregnancy, but an ultrasound can be used for many different medical purposes. In this post you will learn what an ultrasound is, what it is used for, and also the advantages and disadvantages of ultrasound scans.

What is an ultrasound scan?
An ultrasound scan, also known as sonography, uses sound waves to capture images of what is inside a person’s body. Much like a bat uses sounds and their echoes to “see” its surroundings, an ultrasound emits sound too high for a human to hear, and then records the echoes to determine the shape of organs or soft tissues. An ultrasound scan allows doctors to see what is inside the body without making an incision.

What do doctors use ultrasounds for?
Pregnancy. Many expectant mothers have an ultrasound performed so the doctor can see how the unborn baby is doing. Some health problems can be detected this way. Also, the parents get a first peek at the child, sometimes learning the sex of the baby.

Diagnosing health problems in many internal organs, such as:
-blood vessels

Medical Procedures:  Doctors may use an ultrasound scan during certain procedures, such as needle biopsies, to help in precision.

What are the advantages of using ultrasound imagery?
The biggest advantage: an ultrasound is virtually painless, and it does not require an incision.
Ultrasounds are safe! They do not emit any radiation, unlike X-rays and CT scans.
Also, ultrasounds detect soft tissues that X-rays do not capture well.
Ultrasounds are less expensive than many other imaging techniques.

Are there any disadvantages?
Certain areas of the body cannot be imaged using ultrasound. For instance, ultrasound scans cannot go through bone. They also cannot be used in organs where gas is present, such as the lungs.
Ultrasounds are not as detailed as other imaging techniques, and this lack of detail can sometimes result in misleading images.

In conclusion, ultrasound scans allow doctors to see organs and soft tissues without being invasive. This is useful for pregnancies and many other medical conditions. Medical technology continues to advance, giving doctors more and more options to diagnose and treat their valued patients safely and effectively.  If you have been told you are in need of an ultrasound, contact us at Peninsula Radiology at (757) 989-8830 to schedule an appointment.

What Is A CT Scan?

CT ScanA CT scan stands for a computed tomography which scans the abdominal and pelvis which provides diagnostic image testing that will help detect diseases in the small bowel, colon, and many other internal organs in the same region. CT Scans are generally used to determine the cause of unexplained causes of pain.

Are CT Scans Safe?
CT Scans to expose you, very briefly, to a very small amount of ionizing radiation, however it is necessary to help recreate the structures such as organs in the body to determine the cause of the unexplained pain. The tiny amount of radiation that you are exposed to is so small that the increased risks of cancer the person is exposed to cannot even be reliably measured.

When Are CT Scans Done?
CT Scans are often done after the body sustains traumas such as that from a car wreck, work accident, or other traumatic event like a sports injury. These scans will take images of the various parts of the body including cross-sectional images of the body to see if trauma or injury was sustained.
CT Scans are then used to determine plans of treatments, surgeries, or radiation treatments that may need to be completed to help treat the trauma or the issue. These treatment plans can help the patient get rid of the pain and

What Conditions to CT Scans Help Reveal?
CT Scans can help determine some of the following:
Diagnose muscle and bone issues such as tumors or fractures
Pinpoints various procedures that the patient may need such as a biopsy or if they have something more serious like an infection or blood clot
Detection and monitoring of longer-term diseases such as heart diseases or cancers.
Monitor the effectiveness of ongoing treatments such as radiation or chemotherapy treatment.
Helps detect internal injuries such as bleeding or injuries and internal trauma that was done to the organs.

Pregnancy Notice:
Talk to your doctor if you are pregnant. While the miniscule amount of radiation from a CT Scan is unlikely to harm an unborn baby your doctor may prefer to use other imaging, such as MRIs or ultrasounds just to be safe.

Peninsula Radiology is a full service radiology practice that has team members ready to provide answers about any of the services we provide.  Contact us to make an appointment or ask questions about any of our services.


Fluoroscopy Hampton Roads, VAAt Peninsula Radiology Associates, one of the procedures our interventional radiologists rely upon to properly diagnose and treat patients is called fluoroscopy. We use it many times daily in taking care of patients referred to us for radiologic testing and procedures.

What Is Fluoroscopy?

Fluoroscopy is a vitally important imaging technique used to track the progress of a contrast dye. It is a form of diagnostic radiology that allows moving body structures to be examined via X-ray through the use of fluoroscope and a contrast agent. For doctors and technicians, its images are constantly viewed on a monitor as a kind of moving X-ray.

Fluoroscopic exams are used as diagnostic tools for a number of common medical problems. Some of its uses include:

  • To visualize gastrointestinal issues, a patient may be asked to swallow barium, or a similar contrast material. Once the barium has been ingested, an imaging technician uses fluoroscopy to track the progress of the barium through the patient’s system or pain areas and spot potential problems in real time.
  • In placing cardiac stents and inserting and manipulating catheters for embolization — stopping excessive or traumatic blood flow — and other procedures, physicians rely on fluoroscopy to see exactly where to place them and verify they have been properly placed.
  • Cardiac physicians utilize fluoroscopy to obtain precise images of the heart, veins, and arteries. They also use it to spot potential trouble areas, including narrowed blood vessels and arterial blockages.
  • Some other indications for fluoroscopy exams include: small bowel series; barium enemas; hysterosalpingograms; intravenous pyelograms; voiding cystourethrography; myelograms; arthrograms; biopsies; lumbar punctures; facet injections; orthopedic procedures (such as manipulation of broken bones in fracture reduction); and insertion of implants and checking appropriate position and realignment.

What To Expect During a Fluoroscopy Procedure?

The contrast agent — which allows the image to be viewed when x-rayed — will be introduced into the body via swallowing, injection, or an enema.

  • In general, you will be asked to lie or stand between an X-ray machine and a fluorescent screen after putting on a hospital gown.
  • An intravenous (IV) line may be started in your arm; or a catheter may be inserted.
  • An X-ray scanner produces fluoroscopic images of the body part being examined.
  • The procedure itself is generally painless.

The Benefits of Fluoroscopy

Fluoroscopy causes very little risk to patients. The amount of radiation exposure in fluoroscopy is quite minimal.

Additionally, using fluoroscopy is much safer than attempting the multiple procedures in which it is used without its value of real-time, moving images for physicians and technicians. For example, attempting to place a cardiac stent without fluoroscopy would be very risky to the patient, and the procedure would take much longer.

Fluoroscopic equipment and safety measures help reduce the risks associated with the procedure by incorporating:

  • Increased X-ray filtration to reduce the possibility of radiation injuries during long procedures
  • Displays of the duration, rate, and cumulative amount of radiation exposure patients receive
  • Tighter controls on the size of the X-ray field to reduce the amount of radiation that falls outside the image target area

Please contact us at Peninsula Radiology Associates at (757) 989-8830 to set up an appointment and to discuss any questions or concerns you may have regarding fluoroscopy or the many other procedures we use daily. Doctors throughout the Peninsula rely on us — partnering with the Riverside Hospital System — to provide them with extremely accurate test results, and our clients appreciate our patient-centered philosophy.                                              


Season’s Greetings from Peninsula Radiology

Season’s Greetings and Happy Holidays from our family to yours, at Peninsula Radiology!pra holiday

International Day of Radiology: Emergency Radiology

Emergency Radiology Hampton Roads VAThe International Day of Radiology is building greater awareness of the value that radiology research, diagnosis and treatment contribute to safe patient care, and better understanding of the vital role radiologists perform in healthcare delivery. November 8, 2017 marks the sixth annual International Day of Radiology (IDoR). This year’s theme is dedicated to emergency radiology, and the essential role that radiologists play in the emergency room.

The International Day of Radiology is celebrated on November 8, because it is the anniversary of the 1895 discovery of the X-ray by German physicist Wilhelm Röntgen.

Radiologists are not always the most visible members of the healthcare team, but, in many cases, they are the ones who provide the answers about a patients’ condition. Our radiologists use images produced with a variety of techniques and technologies, to pinpoint the exact nature and location of your fracture, whether your head has sustained any serious damage, and whether your stomach pains are due to a swollen appendix.

The International Day of Radiology serves an excellent opportunity to build greater awareness of the value that radiology research, diagnosis and treatment contribute to safe patient care, and better understanding of the vital role radiologists perform in healthcare delivery.

Radiologists in the emergency room increase the quality of care and treatment of patients.

Breast Cancer Awareness Month

breast-cancer-awareness-monthOctober is Breast Cancer Awareness Month! This annual campaign was created to increase awareness of the disease. Most people are aware of breast cancer, but often forget to take the actions necessary to detect the disease in its early stages and encourage others to do the same.

Make your Mammogram a Priority

At Peninsula Radiology, we want to encourage women to get their yearly mammograms, and invite others to do the same. Breast Cancer is the most common cancer, and the second leading cause of cancer-related deaths in women in America. Before the onset of mammography screening, the death rate from advanced breast cancer remained unchanged for 50 years.  Since 1990, this rate has decreased by 30 percent, and recent studies suggest that mammograms may be more effective than previously thought, reducing breast cancer mortality by more than 30 to 60 percent.

It is important for physicians to educate their patients on the benefits of mammography, and to provide them with the proper resources, so that they may make the best decisions for their well-being. Early detection is key and keeping an annual appointment for a mammogram can save lives.

How do I get a Mammogram?

We make it easy and convenient for you to schedule your annual Mammogram. Thanks to Riverside’s Self-Scheduler, you can now schedule your screening mammogram from any computer, at any time. The Self-Scheduler is simple and quick to use. You will first need to create an account by selecting a username and password. Once your account is setup, you will be able to schedule, re-schedule or cancel your appointment at your convenience.

Doctor’s Advice

Dr. David Schengber says, “The more squeeze you can tolerate, the better we can detect disease. There is a lot of emotion, stress and anxiety associated with mammograms and breast cancer. But make getting a mammogram a habit, something you do every year. Just like getting your teeth checked.” -David Schengber, MD, the lead radiologist at Riverside Walter Reed Hospital.

September is Ovarian Cancer Awareness Month

September is Ovarian Cancer Awareness MonthSeptember is Ovarian Cancer Awareness Month. As one of the most deadly cancers, it is crucial to raise awareness and increase patient education about ovarian cancer. As there is no test for ovarian cancer, recognizing the symptoms and being diagnosed early are critical to saving lives.

Ovarian cancer symptoms are often subtle and difficult to diagnose. However, some symptoms of ovarian cancer can include: 

  • Bloating
  • Pelvic or Abdominal pain
  • Difficulty eating or feeling full quickly
  • Urinary urgency or frequency

Other symptoms may include:

  • Nausea, indigestion, gas, constipation or diarrhea
  • Extreme fatigue
  • Shortness of breath
  • Backaches

Talk to your doctor if symptoms last more than 2-3 weeks. You are your best advocate!

Ovarian cancer does not discriminate. It can strike a woman of any race or at any age. Women with certain risk factors may have a greater chance of developing ovarian cancer. These risk factors include:

  • Family history of breast or ovarian cancer
  • Personal history of cancer
  • Women over the age of 55
  • Women who were never pregnant
  • Women on menopausal hormone replacement therapy

Spreading the word about the symptoms can help save lives. It is our goal to promote awareness and early detection of ovarian cancer through advocacy and education, while providing support to people affected by ovarian cancer.

Orthopedics and Radiology: An Effective Pairing

Orthopedics and Radiology: An Effective PairingOrthopedics and radiology are separate specialties. Orthopedics focuses on diagnosing and treating issues with the musculoskeletal system: bones, tendons, joints, muscles, nerves and how they all fit together. Radiology specializes in diagnosing and treating illnesses and injuries using a variety of medical imaging techniques and radiation.

These two specialties are incredibly effective when used together in the diagnosis and treatment of a wide variety of conditions. For instance, when evaluating a patient with osteoarthritis, a radiologist can see exactly what is going on inside the affected joints; and the orthopedist can prescribe treatments based on the imaging results.

Radiology and orthopedics cooperate to diagnose and treat many other conditions, including:

  • Broken bones: radiology provides clear images of the break and allows the orthopedist to plan the most effective way to realign and support the healing of the injury.

  • Spinal problems: spinal injuries, broken vertebrae, spinal degeneration and deformities are clearly displayed using diagnostic imaging. This guides the orthopedic treatment team in designing and carrying out the most effective treatments, which can include surgery, braces and physical therapy.

  • Sports injuries: sports injuries are common, and diagnostic imaging allows for accurate diagnosis and treatment planning.

  • Tendon and ligament injuries: tendons and ligaments can be torn or strained in falls, sports and work-related injuries. Radiology clearly shows the extent and precise placement of the injury so that the orthopedist can plan the most effective course of therapy, surgery or other treatments.

  • Congenital deformities: many congenital deformities affect children; the entire field of orthopedics was founded by a physician who wanted to help these children. Diagnostic imaging provided by a radiologist provides clear pictures of what exactly is going on in the body and helps the orthopedist diagnose and plan treatment.

  • Evaluation of joint degeneration: Hip, knee and shoulder degeneration is very common; repairing and replacing damaged and degenerated joints are some of the most frequent orthopedic surgeries. Radiology guides the orthopedist in planning treatment.

For over 50 years, Peninsula Radiology Associates has provided outstanding, comprehensive diagnostic imaging and radiological services for the Virginia Peninsula. Please contact us for all your medical imaging needs at (757) 989-8830. We have 7 locations on the Peninsula for your convenience!

PET Scan vs. CT Scan: What’s the Difference?

PET Scan vs. CT Scan: What's the Difference?Your doctor decides to order a test to rule out certain brain disorders in light of your all-too-frequent severe headaches. Which test is he more likely to order, a PET scan or a CT scan? Making sense of current technology can be confusing, given how many different ways radiologists can look inside the human body to detect problems and monitor existing conditions and treatments.

PET Scan

A PET (positron emission tomography) scan is an imaging test that uses radiation to allow a doctor of radiology to check for diseases in your body. A PET scan produces 3-D colored images and involves the use of a special dye containing radioactive tracers. When these tracers are highlighted under a PET scanner, they allow the radiologist to not only see your organs and tissues, but also to see how well they are functioning. A PET scan can measure vital processes such as blood flow, how efficiently your body is using glucose, oxygen use, and more.

PET scans are most commonly used to detect conditions and disease processes including:

  • cancer

  • heart problems

  • brain disorders

  • CNS (central nervous system) problems

  • epilepsy

PET scans are also used to monitor how a condition is progressing or how effective the ongoing treatment of a condition is. Unlike a CT scan, a PET scan shows problems at the cellular level. PET scans are often used along with CT scans, X-rays or MRI scans to obtain not only an image, but also a clear idea of how tissue and organs are functioning in real time.

CT Scan

The “CT” in CT scan stands for computed tomography. It uses special X-ray equipment to help detect a variety of conditions and diseases by producing multiple cross-sectional pictures of the inside of the body. These images can then be reformatted in several planes, even to the point of creating a three-dimensional image of a part of the body. The radiologist can view these images on a computer monitor and transfer them to film, a CD or a DVD. The images produced by a CT scan provide greater detail than the images produced by standard X-rays.

Because these images are produced so quickly, CT scans are often used in emergency situations when a fast diagnosis can literally save a life. They’re often used to look inside the chest, abdomen and pelvis because they provide detailed, cross-sectional views of all types of tissue. In addition to being the test of choice for emergencies, CT scans are also routinely used for diagnosis of:

  • tumors

  • vascular diseases and aneurysms (both pulmonary and aortic)

  • spinal problems

  • skeletal problems (showing even very small bones and surrounding tissue and muscles)

A CT scan is also a helpful tool for:

  • guiding biopsies

  • planning for surgery

  • planning and guiding radiation treatments

  • monitoring a patient’s response to chemotherapy

In some CT scans, a contrast dye is used to enhance visibility of the part of the body being examined.

If you would like to request a PET scan or a CT scan, please contact us at Peninsula Radiology Associates at (757) 989-8830. We have served the Virginia Peninsula for more than 50 years with a well-earned reputation for state-of-the-art equipment, expertise and compassion.