Med-Surg - Musculoskeletal System, part 2: Diagnostic Procedures

by Cathy Parkes November 12, 2021 Updated: December 07, 2022 3 min read

Full Transcript

Hi, I'm Cathy, with Level Up RN. In this video, I will be covering key diagnostic procedures related to the musculoskeletal system. At the end of the video, I'm going to give you guys a little quiz to test your knowledge of some of the key points I'll be covering in this video, so definitely stay tuned for that. And if you have our Medical-Surgical Nursing Flashcards available from leveluprn.com, definitely pull those out so you can follow along with me.

First up, let's talk about an arthrocentesis, which is aspiration of synovial fluid from the joint cavity. And we may be removing some of the synovial fluid in order to assist with diagnosis of an infection.

So for example, we'll take some of that synovial fluid and run a culture on it to see if the patient has infection. We may also be removing some synovial fluid to help with pain control. So if a patient has severe swelling, removal of some of that fluid can help to decrease their pain. We may also do a arthrocentesis in preparation for the injection of medications into that joint cavity, such as corticosteroids.

Another diagnostic procedure to know within the musculoskeletal system is an arthroscopy. This is where we insert a narrow tube with a camera on the end in order to visualize the internal structure of a joint, and it also allows for the collection of biopsies. If we are doing an arthroscopy on a knee, the patient needs to be able to bend their knee at least 40 degrees and there cannot be any active infection present in that knee.

Then we have a DXA, which is a dual X-ray absorptiometry. And this procedure uses low levels of X-rays to measure a patient's bone mass.

So it is used to diagnose osteoporosis, which we will definitely be talking more about later in this playlist.

Then we have nuclear scans, which are used to identify fractures, bone cancer, as well as bone infections.

So for this procedure, a radioactive substance or isotope is administered to the patient about four to six hours before the procedure. And this radioactive material will gather in places of chemical or physical changes in the bone. So if the patient has bone cancer, for example, that's going to cause rapidly replicating cells in the area of the bone cancer. And this radioactive material will definitely be attracted to that area and gather in the site of that bone cancer. Then when we do the scan, the nuclear scan of the patient, we will see this hot spot where this radioactive material has gathered. So nuclear scans can be repeated at 24, 48, and 72 hours.

And then finally, we have something called an electromyography, which is used to evaluate muscle weakness.

For example, if we're trying to diagnose myasthenia gravis, which we will be talking about in this playlist, then an electromyography would definitely be helpful. So during this procedure, we have needles that are inserted into the muscles and the electrical activity of the muscle is recorded. And my understanding is that this is not a comfortable procedure. It's not like super painful, but it is definitely not pleasant

All right. Time for a Quiz. I have three questions for you. First question, what test measures bone mass and is used to diagnose osteoporosis? The answer is a DXA or dual-energy X-ray absorptiometry.
Question number two, what test records the electrical activity of muscles and is used to evaluate muscle weakness? The answer is an electromyography.
Question number three, what procedure involves aspiration of synovial fluid from a joint cavity? The answer is arthrocentesis.

All right. That's it for diagnostic procedures of the musculoskeletal system. In my next video, we will start talking about disorders, so definitely stay tuned for that.


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