Out Patient Investigation and Treatment

When I need an X-Ray, ultrasound scan or MRI scan of your shoulder I will refer to the Ulster Independent Clinic or Northern MRI. Your investigations will be reported by my colleague Dr Arthur Grey, Consultant Musculoskeletal Radiologist. You can read about his background and services offered below. The results of your investigations will be available within 48 hours and you will be in a position to be reviewed at that stage.

Dr Arthur Grey Consultant Musculoskeletal Radiologist

Medical Education.

The Queen’s University of Belfast Medical School 1984-89. Graduated MB BCh BAO with honours.

Membership of the Royal College of Physicians part 1 1991.

Radiology training Northern Ireland Training scheme 1991-1996.

Fellow of the Royal College of Radiologists 1995.

Training in musculoskeletal and oncological radiology 1995-96 at Musgrave Park Hospital, Belvoir Park Hospital, Royal Orthopaedic Hospital Birmingham and the Christie Hospital Manchester.

Appointed consultant at Musgrave Park Hospital and Northern Ireland Cancer Centre August 1996.

Dr Grey remains a full time consultant in both hospitals to the present day. He has over 20 years experience in musculoskeletal radiology reporting.

Services provided at the UIC

Xray reporting.

Ultrasound.   For an ultrasound examination of the shoulder, jelly will be applied to it along with an ultrasound probe and the tendons will be examined by moving the arm into four different positions. I will discuss the result with you and a typed report will be sent to Mr. Thompson.

Ultrasound guided injection. A routine ultrasound examination will be undertaken in the first instance to determine if the injection is appropriate and to determine the site for the injection. The skin will be marked with the blunt end of the needle. Consent will be obtained following a discussion of the risks and potential benefits. The skin will be cleaned with iodine and a steri-drape applied. Then, a small injection of local anaesthetic will be made into the skin to numb it. This is followed by an injection of steroid and long acting local anaesthetic into the bursa. This should not be unduly painful. The steroid may take up to 2 weeks to work maximally. You should not drive home if possible. You should refrain from overhead activity with the arm for 48 hours.

MR arthrography.  This involves an injection of dye into the joint to distend it and to reveal the intra articular structures. The injection is undertaken in the xray screening room. You will be asked to give consent following a discussion about the risks and contra indications. You will lie supine on the table. The skin will be cleaned with iodine and a steri drape applied. A small injection of local anesthetic will be made into the skin. Then a very fine needle is inserted into the joint. Initially an X-ray dye will be inserted to confirm the correct position of the needle. Then the MRI dye will be injected. This is mainly saline with a tiny amount of gadolinium (dye) added. Thereafter, you will be taken to the MRI suite for the MRI examination. You should not drive home. You can drive the following day. You should refrain from overhead activity with the arm for 48 hours.

Hydrodilatation.  This is very similar to the procedure for the MR arthrogram. However, in this case saline is injected into the joint with steroid to distend it and to break down adhesions. Maximal success is achieved to the fluid injected does not naturally leave the joint into an adjacent bursa or soft tissues. You cannot drive home but you can drive the next day. You should continue with your physiotherapy / exercises.

Durolane injection. This is similar to the procedure for the mr arthrogram. Rather than an injection of saline, an injection of durolane is made into the joint. This acts as a lubricant and joint distender and is made of hyaluronic acid. You should not drive home if at all possible. You can drive two days after the injection. You should refrain from normal activities or exercise etc. for 48 hours after injection.

MR reporting. This is undertaken at the Ulster Clinic or Northern MRI and I aim to provide a 48 hour turn around. You will be scanned by MRI radiographers. The scans will be reported by me in the evening time and the report sent to Mr. Thompson within 48 hours of your scan.

Additional Physiotherapy Practices

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