New Techniques in Interventional Musculoskeletal Radiology PDF

Preface

While thinking about this book, several thoughts came to mind. The first concerns the importance of procedures in musculoskeletal radiology. Not superficially related to this, but nonetheless important in understanding the relevance of procedures, is politics. Allow me to explain.

Several authorities have commented that radiology has many more subspecialty societies than almost any other specialty. They have suggested that this dilutes the political interests of radiology and ultimately may be the seed of its demise and the dissemination of the field into the various clinical specialties that use its services.

On the other hand, the vibrancy of these subspecialties confirms the complexity of radiology and the importance of radiology to the clinical disciplines each of us interacts with every day. This interaction is what enhances the vigor of radiology and, for the authors of this book, the vigor of musculoskeletal radiology. Being in tune to your customers, while understanding imaging technology and three dimensional anatomy, allows us to be intellectually agile.

This intellectual agility of musculoskeletal radiology has led to the rapid evolution of this field within the last decade to decade and a half. We, the editors, consider ourselves fortunate to be on the cusp of this froth and to see the rapid changes that have occurred in musculoskeletal radiology over a relatively short period of time. We have rapidly transitioned from a subspecialty that is predominantly filmed to one that is more dependent, and in some ways codependent, on advanced imaging.

Interestingly, in this rapid evolution there has been no single disruptive technology. All that we've done is build on what we have done in the past and our understanding of what new technologies will allow us to do. This brings us to interventional procedures. There is a confluence here: three dimensional imaging and advances in percutaneous and minimally invasive tools combined with a better understanding of the natural history of disease and medical interventions the growth of MR and ultrasound has allowed us to obtain.

As a subspecialty we have progressed in less than two decades from a field where we were mostly limited to arthrography for our musculoskeletal procedures to today, where interventional radiologic techniques and procedures form the largest component of our daily work. This is the focus of this book.

This book is an attempt, hopefully successfully, to put together many experts in different specific procedures within radiology and to allow them to describe, in detail, the when, the where, the why, and the how of these procedures. We have done this in a detailed way for a sophisticated audience. We have also tried, in the beginning of the book, to add some background information about procedures that is not readily available: the histologic evaluation of tumors, the pharmacokinetics of local anesthetics, as well as several others. Each chapter following this is devoted to a specific procedure, which is covered in detail. We have selected not only the procedures that are most commonly used, but also procedures that are less commonly used, as those procedures may be more frequently used in the future.

Each of the chapter authors has done an outstanding job in bringing together this material. The politics of whether the growth of subspecialties within radiology is good or not aside, procedures are, to a large degree, where musculoskeletal radiology is heading. Because of the dependence upon imaging both for localization as well as assessment of therapeutic outcomes, we are confident that this material will remain within the confines of radiology, and it is our hope and belief that, in the future, they will be an even more important part of the subspecialty of musculoskeletal radiology.

We are reminded of a quote by a friend of ours—"I did not become a radiologist to be a doctor"—which to some would be the way bone radiology was practiced 20 years ago. Now the specialty has turned 180 degrees towards patient care. Leaving the humor of that quote aside, this is what many of us now do. We hope that our readers enjoy this book and are able to treat patients better because of it. That would make the labor that all these chapter authors have undertaken so well all the more worthwhile.