Common investigations
Investigations
Below you will find some further information on some of the common investigations you may undertake following a consultation with Mr Cox. You can find more information on some of the many conditions that Mr Cox treats in the patient information section on this site.
If you have any questions regarding any of the information on this page or would like to book an appointment then please get in touch with Mr Cox’s secretary Sophie Feist. Information on pricing can be found here.
X- rays
Fluroscopy
Ultrasound
MRI
CT Scans
Steroid Injections
X-rays
X-rays are a common investigation which produce an image of the inside of your body. Radiation is passed through your body but blocked by denser tissues, the difference in ‘penetration’ produces a picture similar to a photograph. X-rays are good at showing problems such as arthritis, fractures and calcific deposits but are less useful at looking at soft tissues.
Having an x-ray is a painless, non-invasive procedure. You will be asked to stand next to a wall, or lie on a table which contains an x-ray sensitive film. You will need to keep still, to ensure that the image is not blurred. The amount of radiation you are exposed to is minimal, but care is taken to keep the number of x-rays you have to a minimum.
Fluroscopy
Fluoroscopy is a dynamic type of X-ray that is particularly useful when undertaking procedures. It can allow accurate administration of local anaesthetic / steroid injections to joints for diagnosis and pain relief. I also use this method during fracture fixation to ensure the surgery is successfully performed
Ultrasound
Ultrasound is a non-invasive scan that produces images using high-frequency sound waves. The sound waves are directed at your body and are able to pass through soft tissues and liquid. When they meet a solid object, such as a tendon or bone they bounce back where they are translated into an image.
Ultrasound is thought to be completely safe (it is what they use to look at babies!) and is particularly good at investigating soft tissues which are not deep inside the body. This includes the rotator cuff tendons, as well as areas around the elbow, wrist, and hand.
Ultrasound can be useful to guide diagnostic and pain-relieving injections so that they can get to just the right bit’. After having an anti-inflammatory injection (steroid) or hyaluronic acid, you should rest the area for a few days before being able to carry on as normal. You may feel that increased discomfort or pain in the area injected for the first two days – this is normal.
If you become unwell or notice swelling, redness or warmth around the injection site please let me know.
MRI
Magnetic resonance imaging (MRI) is a painless and non-invasive procedure which creates detailed images of your body using a strong magnetic field. They are particularly useful when looking at tissues deep inside the body and can give information regarding bones, cartilage, ligaments, tendons, muscles and areas of inflammation. I occasionally recommend the addition of a special dye (injection) to look for specific problems.
MRI scans are safe for most people but cannot be performed in patients with metal clips or fragments in their eyes or brain, or in most situations where the patient has a pacemaker or spinal stimulator. The radiographer and I will discuss this with you prior to a scan being performed.
Having a MRI scan normally takes about 30 minutes and can be quite noisy! You will have to lie on a bed which moves through the scanner which looks like a small tunnel. If you suffer with claustrophobia you may wish to arrange a visit to look at the scanner prior to the date of the scan to ensure you are happy to proceed.
CT Scans
Computerized tomography (CT) scanning is a non-invasive and painless procedure where a series of X-rays are taken and then converted into a 3D image. This is particularly useful for looking at bony structures and can be useful for fracture assessment as well as allowing accurate sizing of prostheses in joint replacement surgery.
You will have to lie on a bed which moves through the scanner which looks like a tunnel. I occasionally recommends the addition of a special dye (injection) to look for specific problems. This investigation has a relatively increased exposure of radiation and I will only recommend this when the benefits outweigh the risks.
Steroid Injections
Steroid injections are common to treat a number of shoulder, elbow and hand conditions. They are normally well tolerated and give good relief of symptoms from a number of conditions. There are of course uncommon problems which might lead you to regret having the injection including transient or poor response, steroid flare (an acute increase in pain which settles over 48 hours), transient facial flushing, blanching of the skin, or fat necrosis (dimpling of the fat). Steroid injections do carry a risk to tendons and cartilage as well, although the degree of this is difficult to quantify but means that is best to keep the number of injections to a minimum.