The musculoskeletal imaging section of OHSU Diagnostic Radiology provides comprehensive evaluation of bones, joints, muscles, and nerves. A complete spectrum of imaging modalities is employed, including MRI, CT, ultrasound, x-ray and fluoroscopy, and all studies are performed on state of the art equipment. We use the latest imaging techniques in order to address the specific concerns of our referring clinicians. 

The section also maintains a robust musculoskeletal interventional practice, offering a wide array of services performed on a daily basis. These include fluoroscopic- and CT-guided joint injections; CT-guided spine, pelvic, and extremity bone and soft tissue biopsies; ultrasound-guided biopsies, aspirations, and injections; and CT-guided osteoid osteoma RFA (radiofrequency ablation). 

We work closely and hold weekly and monthly case conferences with referring clinicians in orthopedic surgery, sports medicine, physical medicine and rehabilitation, rheumatology, and other clinical services and in order to provide the best possible care for our patients, and to discuss imaging findings and intervention. 

Meet our Musculoskeletal Imaging and Intervention Radiologists.

Clinical Experience 

Fellows typically alternate in the diagnostics versus procedures roles every other week. The diagnostic MSK service interprets a large number of imaging studies daily, including radiography, MRI, CT, and ultrasound. The diverse case mix includes high-end sports MR and an active bone and soft tissue sarcoma service (Knight Cancer Institute). Fellows work side-by-side with attendings, reviewing cases throughout the day and receiving one-on-one teaching, gradually assuming more responsibilities as the year progresses. 

In addition to interpreting studies, fellows also develop a deep understanding of MRI and CT protocols by tailoring examinations for each patient, working closely with technologists to modify protocols according to specific clinical questions and troubleshooting challenging scenarios. 

While expected to be in the hospital while on daily clinical service, all fellows have home workstations allowing for increased flexibility including the ability to take call from home. 

The section also performs a large number of procedures each week, including: 

• Fluoroscopic-guided therapeutic injections/aspirations and MR arthrography 
• CT-guided biopsies/interventions including spine 
• Miscellaneous injections 
• RF (radiofrequency) ablation 
• Ultrasound-guided biopsies/interventions 

This includes all MSK-related procedures for pediatric patients via Doernbecher Children’s Hospital. Fellows are an integral part of this service and work closely with referring clinicians to decide on appropriate plans of action and patient management. 

Program Highlights 

Our Diagnostic MSK Fellowship is Non-ACGME-accredited and requires a one-year commitment. Candidates must be Board Certified or Board Eligible radiologists, with selection through the NRMP.

The program is designed to produce well-rounded musculoskeletal radiologists in a collegial environment who are expert diagnosticians and interventionalists. This is achieved through a combination of teaching, clinical work, and ample opportunities for research including protected academic/meeting time. 

Fellows leave the program well-prepared for both private practice and academic settings with strong procedural skills, a balanced fund of knowledge and a solid framework for approaching even the most difficult problems in musculoskeletal imaging.

Approximate annual imaging volumes: 

• Radiography: 57000 MSK CT: 1500 
• MSK MRI: 3700 
• MSK Diagnostic US: 75 
• Osteoid Osteoma RFA: 8 
• CT-guided bone/soft tissue biopsy: 150 
• US-guided biopsy: 50 
• Fluoroscopic-guided injections/aspirations: 500 

Technology and Facilities 

OHSU, Oregon’s only academic health center, is home to multiple state-of-the-art CT and MRI scanners; the vast majority of joint imaging is performed on 3T scanners. 

• OHSU Main Hospital 
• Doernbecher Children's Hospital 
• Center for Health & Healing 
• Portland VA Medical Center 
• Knight Cancer Institute

Faculty and Teaching 

All musculoskeletal radiologists are certified by the American Board of Radiology and have completed musculoskeletal fellowships. 

The Musculoskeletal section is actively engaged with referring clinical colleagues and our fellows are often the first line of communication between services. These critical relationships are maintained and strengthened through weekly Rheumatology-Radiology and Orthopedic Oncology-Pathology-Radiology conferences and conferences which provide valuable insight into the needs of referring providers as well as feedback on imaging interpretation and procedures. 

In addition to daily clinical teaching and multidisciplinary conferences, the MSK fellowship curriculum includes a monthly lecture series dedicated to covering highly subspecialized topics to ensure our fellows have as complete an education as possible. Finally, the fellowship training is supplemented with journal club, arthroscopy correlation, biopsy rad-path correlation and hands-on ultrasound didactics. In addition to our busy clinical service, the musculoskeletal faculty takes great pride in providing exceptional teaching in the radiology residency program and musculoskeletal radiology fellowship. Direct teaching occurs throughout the day at the workstation and in the procedure suite, complemented by weekly didactic and case conferences. A complete teaching curriculum ensures that our trainees are taught the most current topics and procedural techniques. 

We also have several ongoing academic projects including scientific research, educational exhibits, international teaching efforts, and national, regional, and institutional lectures.

Location

From the slopes of Mt. Hood to the shores of Cannon Beach, Oregon is referred to as a “Pacific Wonderland” for good reason and Portland is perfectly situated to take full advantage of all it.