A favorite game for many children has been to imagine they have a superpower. Typically, a heated discussion ensues about which was the most desirable power with x-ray vision always getting its share of the votes. Fortunately, this is no longer simply a game, and, with the help of technology, we are able to exercise this “power” every day.

Technology has had a profound effect on the practice of medicine. Although perhaps not a hot topic, new imaging techniques have been developed which allow an unparalleled view into the body, be it soft tissue or bone. One of the most common technologies, and one that many Americans are familiar with, is that of ultrasound imaging.

With this device, we can visualize a great variety of soft tissue structures quickly and easily. Although a poor method of looking at bone, moderately good definition can be obtained of various skin, tendon, and joint structures, all without any risk of radiation. Another benefit of ultrasound imaging is that it is a “real time” modality, meaning that the part being looked at can be moved, back and forth, and that movement is seen on the monitor, like a movie. My ultrasound imaging device is used on a daily basis, since it is convenient and easy to use.

When it comes to looking at structures both soft tissue and bony, the most precise and detailed view can be obtained with an MRI device. This stands for magnetic resonance imaging, although it was originally called “nuclear magnetic resonance” imaging, since it actually measures the vibration of the nucleus, which is the core, or center, of an atom. The name was changed early on, because the manufacturers were concerned about the association with the word “nuclear” , the implication being that the device utilizes nuclear radiation. MRI devices have absolutely no danger or risk associated with their use, thus the name change. Unfortunately, they are very expensive to perform, and tremendously costly to purchase. Still, for detail and precision, and for a great variety of problems, it is the gold standard.

Although not nearly so “sexy,” even the basic, commonplace x-ray machine has been affected by modern technology. Whereas some offices continue to use chemical processing of actual x-ray film, most have made the transition to digital x-ray systems, in which the information is recorded by a computer, and the image can then be stored, and manipulated, at will. Numerous advantages exist, from the time required to actually see the picture (seconds!), to the ability to enlarge or alter the density of the image. This is to say nothing of the difficulty and space required to store all those films!

Perhaps even more exciting, and visually arresting, is the very real ability to be a super-man and see a skeleton, watch it twist and turn, a moving image, as though one were wearing those magical “x-ray spex” . Maybe you remember them, cheap ads found in the back of dime store periodicals. This is achieved through the use of fluoroscopy. A C-arm is the name of the device performing fluoroscopic imaging, so-called because the arm of the machine is “C” shaped. The extremity (foot or ankle, in my case) is placed between the ends of the “C” , and the monitor shows the bones, with every movement of every joint clearly visualized on the screen.

This technique is incredibly helpful when performing small incision surgery, where the work on the bones is done through tiny incisions. The benefits of this surgical technique are numerous, including faster healing and reduced pain. But without the ability to have x-ray vision, via fluoroscopic imaging, the minimally invasive surgical technique would not be possible. Fluoroscopy allows this technique to be performed in the office setting, “seeing” every nuance of the work performed.

These new techniques, from ultrasound to fluoroscopy, allow modern day health care practitioners to better diagnose and treat numerous medical conditions. But the goal is always the same: to increase longevity, to improve health, to be more mobile, to be able to walk or run better, without pain. At the finish line?……improved quality of life, a longer life.

Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with an upcoming expansion to the Hancock-Houghton area. McLean has lectured internationally on wound care and surgery, being board certified in surgery, orthotic therapy and wound care. He has a sub-specialty in foot-ankle orthotics. Dr. McLean welcomes subject requests for future articles at drcmclean@outlook.com.

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