What Is a Musculoskeletal Radiologist?

C. Mitchell

A musculoskeletal radiologist is a doctor who specializes in diagnosing and treating muscle and joint problems. Doctors in this specialty are typically experts in how human bones, muscles, and ligaments work together. Their primary role is diagnostic: that is, they use their expertise to determine what exactly is wrong with a patient, usually in a wholly non-invasive way. The doctors usually do this using x-ray or other medical imaging technology. A musculoskeletal radiologist can sometimes treat minor injuries or problems, but conditions that require more advanced treatments, particularly surgery, must be referred to a treatment expert.

A musculoskeletal radiologist reviewing an X-ray.
A musculoskeletal radiologist reviewing an X-ray.

The musculoskeletal system is the network of muscles and bones within the body. Injuries, conditions like arthritis, and other growth and degeneration problems can cause pain and disorders that cannot always be immediately identified externally. It is a musculoskeletal radiologist’s job to conduct medical imaging of the problem areas to figure out what, exactly, is going on.

Like all radiologists, musculoskeletal radiologists use x-rays, fluoroscopy, ultrasound, and computed tomography (CT) scanning technology to effectively look inside of a patient’s body. Since musculoskeletal disorders and injuries affect bones and muscles specifically, this is where these kinds of radiologists focus their attention. Musculoskeletal practice is exclusive, meaning that the these doctors do not concern themselves with internal organs, lungs, or other internal processes.

Though it sounds simple, diagnosing problems with medical scans and imaging can be quite a complex science. It is common for muscle degeneration and bone misalignments to be subtle, and the skill needed to precisely pinpoint them takes a fair bit of practice. Getting a diagnosis wrong also usually carries significant consequences. Recommending a patient for surgery or prescribing an anti-inflammatory drug, for instance, when neither is needed can add problems and headaches for doctor and patient both.

In most places, radiology is one of the most competitive — and with it, most highly paid — medical specialties. A musculoskeletal radiologist is a doctor who has not only specialized in radiology, but usually also has further honed his bone and muscle knowledge in a musculoskeletal fellowship. In most cases, it takes upwards of 10 years to become a musculoskeletal radiologist.

A musculoskeletal radiologist can work in a variety of settings. Most work in private practice, usually taking patients on a referral basis from general practitioners. Private practice radiologists usually have the flexibility to take only a certain kind of patient. They will often treat only joint problems, for instance, or work only with ankles and feet. This sort of hyper-specialization allows the doctors to become true experts in certain limited areas of the body.

Many radiologists, including musculoskeletal radiologists, are also on staff with hospitals. Doctors in this category typically see patients with all sorts of problems, from knee injuries to arthritic shoulders. There are advantages to this sort of practice as well, including broader skill development and the ready availability of other experts for consultation and immediate referral.

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