In the vast majority of cases, an accurate diagnosis can be made based on the medical history and a clinical examination. In many cases, however, it will be beneficial to supplement with:
X-ray used primarily for suspected fractures, fatigue fractures and bone tears. The examination involves X-ray irradiation.
CT scan, used for certain bone fractures as a supplement to a standard X-ray examination. CT scans are more accurate than X-rays, but involve much higher levels of X-ray radiation and should therefore be minimised in children and adolescents.
Scintigraphy, used especially for suspected fatigue fractures. The examination involves the injection of radioactive substances and should be minimised in children and adolescents. It has been replaced to some extent by ultrasound and MRI.
MRI scans are widely used to assess the condition of joints and other deep structures in particular. The examination involves magnetic radiation, which, as far as we know, is harmless. However, it is important not to contain anything magnetic.
Ultrasound scanning, the most widely used, cheapest, fastest and most accurate examination, is routinely used in many places as part of the clinical examination. Ultrasound scans can visualise conditions during movement (dynamic scanning) and detect the flow of blood vessels and tissue (Doppler examination) and stiffness of tissue (elastography). Drainage of accumulations (blood, synovial fluid, etc.) and injections can be performed ultrasound-guided, making it possible to position the needle tip with great precision.
Diagnostic blocks with local anaesthesia can help provide information about where the pain is being triggered and are associated with only modest risks.
Arthroscopy, used for diagnostic examination of conditions inside joints when it is not possible to determine what is wrong inside a joint clinically and imaging-wise. Compared to the other examinations, arthroscopy is associated with a number of risks.
