August 1, 2006 Orthopedic injuries are among the most common reasons people visit the doctor. Whether it's pain in the knee, hip or shoulder, doctors have a difficult time making an exact diagnosis without surgery. Now a new robot could make treating an injury more precise.
GAINESVILLE, Fla. -- Orthopedic injuries are among the most common reasons people visit the doctor. Whether it's pain in the knee, hip or shoulder, doctors have a difficult time making an exact diagnosis without surgery. Now a new robot could make treating an injury more precise.
From rock climbing to surfing, Ginger Stirna lives extreme sports ... and has an extreme shoulder injury. The occupational therapist says competitive swimming is to blame. "Basically I've allowed my shoulder to, kind of, become more hypermobile than it should be," she says.
Stirna knows these kinds of injuries are difficult to treat. Even the best orthopedic surgeons can't be sure what the problem is until surgery gives an inside look.
"We can be surprised, which -- it's not good to have a surgeon surprised," Thomas Wright, an orthopedic surgeon at the University of Florida in Gainesville, tells DBIS.
Still pictures, or X-rays, don't give enough information. The science fiction dream -- as seen with the skeletons in "Total Recall" -- is cool, but it would come with a massive dose of radiation.
Meet GatorRay. Mechanical and aerospace engineer Scott Banks designed this robotic system to expose patients to less radiation and give more information than the current technology. "We say, 'Hold still. Relax your muscles,' while we have them do some kind of CT scan or MR scan, which is crazy," Banks, of the University of Florida, tells DBIS.
The patient wears a patch lit with LEDs on the body part being tracked. Then, eight cameras around the room capture the LED motion 500- to 1,000-times per second. A computer tells the robotic arm how to mirror the movements. Now, GatorRay carries a camera. Soon it will carry an X-ray source, and a second robot will carry an X-ray sensor.
The bulky fluoroscope used now only allows for limited motion -- nothing natural. Developers of GatorRay believe it will actually expose patients to less radiation than current imaging systems do. Exposure to too much radiation can increase cancer risk.
GatorRay will be programmed to release X-rays only when it can tell it will get a good image.
Wright says, "Currently today our tools are pretty crude." But there's nothing crude about the system designed to give doctors a superhuman glimpse at the way our bodies work.
BACKGROUND: An engineer has designed a robot to shadow and shoot X-ray video of sufferers of orthopedic injuries as they walk, climb stairs, stand up from a seated position, or do other daily activities. The goal is to add the motion information to the still images of the patient's bones, muscles and joints, with an interior view of them in action during normal physical activity.
HOW IT WORKS: A patient wears an LED-lit patch on the body part to be studied, and several cameras placed around the room – connected via a networked computer – command the robot to hone in and track the joint. The computer then analyzes the collected data. The robot has a mechanical arm which will eventually hold lightweight equipment for shooting X-ray video. A second robot will be added to the system to hold the sensor that captures images of the body as moving videos. The robots will be attached to a fixed base, but if placed on wheels, they will be able to follow a person around, tracking and recording movement.
ADVANTAGES: By merging these full-motion X-rays with other images, orthopedic surgeons will be able to make more accurate diagnoses and suggest better treatments. Injuries are currently diagnosed through still imaging techniques, or just by touch. But conventional imaging techniques, like X-rays, CT scans, and MRIs, provide only a small view of a very limited range of motion in a controlled laboratory setting. Injuries tend to manifest themselves when a joint is in motion. The most common are kneecap and shoulder injuries. Exploratory surgery is the only way to determine whether or not there is an injury. The new method would allow doctors to observe and measure how the joints are moving when patients are actually using them.
ABOUT X-RAYS: Like visible light, X-rays are wavelike forms of electromagnetic energy (light) carried by tiny particles called photons. The only difference is the higher energy level of the individual photons, and the corresponding shorter wavelength of the rays, which make them undetectable by the human eye. X-ray photons have energies that range from hundreds to thousands of times higher than those of visible photons. X-ray machines image the outline of bones and organs, while a CT scan machine forms a full three-dimensional computer model of the inside of a patient's body. Doctors can even examine the body one narrow slice at a time. The X-ray beam moves all around the patient, scanning from hundreds of different angles, and the computer takes all that information to compile a 3D image of the body.
WHAT ARE ROBOTS: Robots are manmade machines intended to replicate human and animal behavior. Robots are made of roughly the same components as human beings: a body structure with moveable joints; a muscle system outfitted with motors and actuators to move that body structure; a sensory system to collect information from the surrounding environment; a power source to activate the actuators and sensors; and a computer "brain" system to process sensory information and tell the muscles what to do.
Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.