Abstract
The spectrum of effective musculoskeletal (MSK) interventions is broadening and rapidly
evolving. Increasing demands incite a perpetual need to optimize services and interventions
by maximizing the diagnostic and therapeutic yield, reducing exposure to ionizing
radiation, increasing cost efficiency, as well as identifying and promoting effective
procedures to excel in patient satisfaction ratings and outcomes. MSK interventions
for the treatment of oncological conditions, and conditions related to sports injury
can be performed with different imaging modalities; however, there is usually one
optimal image guidance modality for each procedure and individual patient. We describe
our patient-centered workflow as a model of care that incorporates state-of-the-art
imaging techniques, up-to-date evidence, and value-based practices with the intent
of optimizing procedural success and outcomes at a patient-specific level. This model
contrasts interventionalist- and imaging modality-centered practices, where procedures
are performed based on local preference and selective availability of imaging modality
or interventionalists. We discuss rationales, benefits, and limitations of fluoroscopy,
ultrasound, computed tomography, and magnetic resonance imaging procedure guidance
for a broad range of image-guided MSK interventions to diagnose and treat sports and
tumor-related conditions.
Keywords
sports - tumor - intervention - magnetic resonance imaging guidance - computed tomography
- ultrasound