In-office arthroscopy, an alternative to MRI for some patients

What is diagnostic needle imaging?

“The MRI is inconclusive,” or “It looked different than the MRI.” These are just two statements we would like to eliminate with Diagnostic Needle Imaging.

This new hand-held arthroscope technology is utilized by our physicians that is rapidly changing the way orthopedics is practiced. We are utilizing technology in 2 ways: for diagnosing injuries and conditions inside the joint (we refer to this as in-office arthroscopy or needle imaging) and for surgical care of certain orthopedic conditions (Needle Arthroscopy).


About Needle Imaging

Needle Imaging, also called in-office arthroscopy, is an alternative to MRI for some patients. The “needle on a camera” technology allows for our physicians to look inside the joint in an appointment in our office setting.

An injured knee or shoulder can take weeks to visualize and diagnose with an MRI. Lots of waiting for appointments, waiting for results and more waiting for treatment decisions. The result of an MRI is a picture. Needle Imaging, however, skips those steps by providing surgeons and patients with a real-time diagnosis in 1 visit. This procedure is administered by our physicians while you remain awake using a local numbing of the joint. The innovative arthroscope produces a high-resolution video, allowing patients to get real-time, accurate answers to their joint pain.

Patients find it fascinating to watch what’s happening inside their knee or shoulder! Not into needles and anatomy? No problem. Patients can wear VR goggles during the 10-minute procedure and get the doctor’s recommendation after the procedure is complete.

Needle Imaging: What to Expect

The total diagnostic procedure is about 10 – 15 minutes. It is administered in our office. Key steps include:

  1. Sterile the procedure site.
  2. To reduce pain, a local anesthetic is provided to numb the skin and surrounding area.
  3. The doctor inserts the needle camera into the joint.
  4. The doctor examines joints and views a vivid picture on a high-resolution tablet, providing real-time diagnosis.
  5. After the procedure, the area is covered with a bandage and the patient returns to normal activities and determines a treatment plan with the physician.

Some patients choose to watch the procedure. Others prefer to utilize VR goggles. Whatever the option, patients report high satisfaction with the procedure. The clarity in the treatment path with less waiting helps patients feel confident recovery is close.

You can watch a full video of the procedure here.

Needle Imaging Benefits

Fast. Accurate. Immediate answers.

An injured knee or shoulder may take weeks to visualize and diagnose with an MRI. This diagnostic procedure is faster, providing real-time, vivid imaging that benefits both patient and doctor with the answers necessary to determine the best treatment – all in just one visit. Typically, patients can spend less time waiting for results, and more time getting back on the road to recovery.

In a study published in the Journal of Arthroscopy, the accuracy, sensitivity, and specificity of needle arthroscopy were equivalent to surgical diagnostic arthroscopy and more accurate than MRI.

Needle Imaging is also a safe alternative diagnostic plan for patients who are not candidates for an MRI.

While insurance coverage varies based on your individual plan, cost comparisons are more cost-effective than an MRI.


This technique is ideal for patients who want immediate answers. It is also ideal for patients who are not candidates for MRIs.  Injuries to the shoulder, knee, elbow, and hip can potentially be diagnosed through this procedure.

Currently, Sano Orthopedics is diagnosing knee and shoulder injuries with this technology.

Risks, Side Effects, Coverage

The procedure cannot be performed on patients with an active infection.  Patients have tolerated the procedure very well, with most reporting little to no pain. It is important to note that every patient is different, and pain may be variable.  In some cases, an MRI may still be necessary if incomplete joint visualization occurs.

Most major insurance carriers cover the procedures. Some insurances do require prior authorization. However, validated procedural history has indicated that prior authorization is patient and plan-dependent. Needle imaging is typically more cost-effective than an MRI. 


Does the procedure hurt?

Most patients report little to no pain in the procedure, although pain tolerance varies by individual. Patients can walk out of the procedure and continue with their daily activities. Many report feeling fullness in the diagnosed joint for 24 -48 hours. 

What does it cost? Is it covered by insurance?

Most insurances cover the diagnostic procedure, although most require prior authorization. Self-pay is also available. Comparison studies have shown diagnostic needle imaging to be more cost-effective than an MRI.

Why haven't I heard of this before?

The technology is new! Dr. Daggett is a leading surgeon helping design this new technology. One challenge for orthopedic clinics is incorporating this into the clinic setting. Also, many physicians are used to viewing joints during a surgical setting where patients are asleep.

As more patients see the benefits and more physicians and practices learn how to utilize the tool, we anticipate it being available in more offices.

Who is a candidate?

This diagnostic technique is ideal for anyone needing to diagnose an orthopedic injury. It is not recommended for patients afraid of needles. It is ideal for patients who cannot do an MRI. Sano Orthopedics uses needle imaging to diagnose shoulder and knee injuries.  

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