Musculoskeletal Radiology

Sports injuries, fractures and complex musculoskeletal conditions

Our pediatric musculoskeletal radiology services are tailored specifically for children’s needs, age and size. We can assess sports injuries, growing bones, muscles, tendons and ligaments, providing both diagnostic procedures (to confirm or rule out a condition) and interventional procedures (to treat a diagnosed condition).

MSK Injection Clinic

The MSK Injection Clinic performs image-guided steroid injections for joints or tendon sheaths for children under the care of a rheumatologist, orthopedist or sports medicine doctor. We also inject contrast dye into a joint (called an arthrogram) before an MRI.

In general, children as young as 6 years old may be able to hold still with proper preparation. We use various distraction devices and strategies with parent participation. Sometimes, light sedation and anxiolytic supplementation will be provided to children if necessary and as requested by your doctor. All procedures are performed under sterile technique in a dedicated procedure room.

To make an appointment

Texas Children’s Hospital providers: Ask your provider to order through EPIC.

Non-Texas Children’s providers: Ask your provider to complete this form and email it to mskradiology@texaschildrens.org. If the procedure you’re interested isn’t listed below or you have questions about a procedure, please email us, and we’ll respond within 1 business day.

Exams may be scheduled and performed at all 4 campuses: Texas Medical Center, West Campus, The Woodlands, and North Austin.

For physicians:

Services provided

Therapeutic anesthetic/steroid injections:

  • For joints, tendon sheaths or bursa for children with injuries, cerebral palsy or rheumatologic or physiatry conditions: Image-guided needle placements followed by anesthetic/steroid injections.
  • For juvenile idiopathic arthritis: Image-guided steroid injections are performed only by referral from a rheumatologist. For injections of the hand, wrist, foot or ankle, a limited non-contrast MRI will be performed beforehand to map and identify joints and tendons that may be inflamed and require directed therapy.
  • For diagnosis: A diagnostic injection is performed to determine if a specific anatomic area is the site that’s causing pain or discomfort. Pre- injection, post-injection and 2- to 3-day follow-up pain scores are also generated. A radiology nurse will call you after the procedure.

Arthrography before an MRI: Your doctor will use an ultrasound or X-ray to inject contrast medium before an MRI.

Ultrasound-guided ganglion cyst fenestration: This procedure is an alternative to surgery for ganglion cysts of the hand, wrist, ankle or foot. An ultrasound is used to confirm the ganglion cyst diagnosis and rule out an underlying mass or alternative diagnosis. Aftercare limits athletic activity for 4 weeks.

Ultrasound-guided platelet rich plasma (PRP) injection and dry needling: PRP and dry needling of ligament, tendon and muscle injuries is an alternative therapy and should only be considered if all nonoperative options have been exhausted, and your doctor is now considering surgery to treat your injury. For PRP injections, we’ll perform a blood draw to extract platelets from your child’s blood, and then inject them into the injured body part under sterile conditions. Don’t take any non-steroidal medication 1 week before or 1 week after the procedure.

Therapeutic hyaluronic acid synthetic joint injections (age 18 and older): We’ll use ultrasound or X-ray to place the needle into an osteoarthritic joint and then inject a synthetic hyaluronic acid derivative. The viscosity (thickness) of hyaluronic acid requires a slightly larger needle.