The best management for arthritis first identifies what type of arthritis it is and then its stage. By doing this, joint damage and disability may be prevented.

In evaluating patients, different imaging tools are used. Routine x-rays are not very helpful because they do not show early changes of disease.

David R. Mandel, M.D. is one of the few rheumatologists in Northeast Ohio who use both musculoskeletal ultrasound and MRI to make a more accurate and early diagnosis of arthritis. He has also been involved in teaching his colleagues in the use of these new techniques.

Ultrasound

Ultrasound has been used for many years in examining many area of the body such as the gallbladder or the circulation for blood clots. Ultrasound is very useful in examining inflammation around joints as well. This has been shown to improve the physician’s skills of examining joints that may not detect early changes.

The ultrasound can help better achieve the ability to remove fluid when the doctor aspirates a joint. We precisely know where the tip of the needle needs to be and can place it there.

The applications of ultrasound in rheumatology are expanding in many areas to examine other structures such as tendons, bursa, and ligaments because it is safe and very accurate.

Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging [MRI] has been used for examining the entire musculoskeletal system including the spine for many years. 0.MRI is considered the goal standard image because of its sensitivity and detail. Cost and convenience can be a barrier to its use.

With MRI, we can see the earliest changes of Rheumatoid Arthritis. We now have new and improved medications that can halt the progression of the disease that will cause some of the deformities. By staging and identifying patients who may need these medications, we have improved the quality of daily life for our patients.

Our office has a very accurate extremity MRI machine that provides the same precision and accuracy as the larger high field machines. This open machine allows patients a more comfortable and less expensive procedure. It is used to scan images of the hands, wrist, elbow, feet, ankles and knees.

When patients schedule their appointment, there are prescreening questions for their safety from the magnet and given information of what to expect with instructions on apparel. A locker is provided for their personal belongings.

DXA

A bone mineral density (BMD) test uses a special machine to measure your bone density to see if you are at risk for osteoporosis. The test lets you know the amount of bone mineral you have in a certain area of bone, including your hip, spine, forearm, wrist, finger, or heel. The test is safe and painless.

Vertebral Fracture Assessment (VFA) is a new, patient-friendly diagnostic tool on DXA bone densitometry equipment that detects unknown vertebral fractures. Dr. Mandel is already utilizing this new tool that will soon become the new standard in osteoporosis testing.

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