Improving diagnostics and treatment of common musculoskeletal conditions:
The use of ultrasound to evaluate musculoskeletal structures was first reported in 1958, and has rapidly expanded over the last five to ten years, mainly in the outpatient clinics of musculoskeletal-trained physicians. Injuries and soft-tissue structures are now viewed in real time, including injuries to muscle bellies, tendons, ligaments, arteries, nerves and even some characteristics of bone. Ultrasound has become a valued tool that assists a trained physician to quickly diagnose and accurately treat a vast range of musculoskeletal pathologies.
Utrasound has a significantly lower cost compared to other imaging methods and most importantly avoids exposure to ionizing radiation. It is a repeatable, noninvasive imaging modality that is capable of providing dynamic tissue assessment. In addition, ultrasound can be used to quickly compare one affected area with another unaffected area when necessary. It is readily used to diagnose rotator cuff pathology, carpal tunnel syndrome and hip pathology, to name a few.
Treatment Guidance and Targeted Applications:
Ultrasound is now used as in-office image guidance for many interventional pain procedures. This includes intra-articular joint injections, soft-tissue injections, aspiration of cyst, nerve blocks and treatment of acute or chronic tendon pathology including tenotomies and the use platelet rich plasma (PRP). Ultrasound guidance routinely improves accuracy and outcomes of these specific procedures. While using ultrasound guidance for an injection, a physician can directly visualize the needle’s path and the immediate structures around it. This direct visualization helps reduce some of the pain that can occur during an injection and reduces the risk of injury to adjacent nerves or blood vessels.
Ultrasound is an exciting and expanding modality in the field of musculoskeletal medicine. It is helping physicians deliver safer and more effective care by improving their diagnostic and treatment methods. Immediate access to better data improves timely care and leads to better outcomes.
Source: AAOS, The Role of Ultrasound-Guided Injections in Orthopedic Sports Medicine: Upper Extremity (www.aaos.org)
Author: Nathan Condie, DO, The SMART Clinic
Dr. Condie is trained and experienced at diagnosing and treating a broad range of musculoskeletal, sports and spine disorders. He has special interest in electrodiagnostic medicine (EMG), an important tool to diagnose nerve and muscle related issues. He also has fellowship training and additional experience with ultrasound-guided interventional pain procedures, and with multiple hands-on treatment modalities.