THE VALUE OF ULTRASOUND
Why do we use ultrasound?
Our practice uses musculoskeletal ultrasound to provide the best
quality of care possible. Our diagnoses are more accurate due to
the images that ultrasound provides, and our injections are more
What can you see by ultrasound?
The answer is - basically everything. Rotator cuff tears, tendinosis,
tenosynovitis (inflammation of tendon sheaths), synovitis (inflammation of the joint lining), fluid in joints and plantar fasciopathy (the disorder formerly known as plantar fasciitis) are examples of conditions detectable by ultrasound imaging. In our opinion, the use of musculoskeletal ultrasound is revolutionizing the practice of sports medicine.
Ultrasound can now be used to diagnose carpal tunnel syndrome (CTS), which is outstanding news. Patients no longer have to suffer through an EMG study for the evaluation of CTS. Exact criteria were established in 2004, correlating the cross-sectional area of the median nerve at the wrist to the severity of disease.
How precise is ultrasound?
Musculoskeletal ultrasound offers a level of diagnostic precision previously unavailable to musculoskeletal specialists. Its anatomic detail exceeds that of MRI for tendons, ligaments, fascia, blood vessels and nerves, and with ultrasound, we can observe your body parts moving, which can provide additional insights. The proper use of diagnostic ultrasound requires training beyond what is available in medical school, residency and fellowship, as well as detailed anatomical knowledge. Ultrasound imaging has changed our understanding of the nature of many physical disorders, examples being plantar fasciopathy (previously called plantar fasciitis), tennis elbow, rotator cuff disease, and pain at the lateral hip (previously called trochanteric bursitis).
All of our injections are ultrasound guided. Although studies have shown that unguided injections can achieve up to 90% accuracy with some joints, with some physicians in some research settings, we believe that even 90% is not good enough. Ultrasound guidance also allows us to avoid nerves and blood vessels. A prime example of this would be a branch the lateral circumflex femoral artery, which crosses in front of the hip joint with an accompanying nerve. These can be avoided during a hip injection only if ultrasound guidance is being used. For any type of injection you might be considering, we would be happy to explain the benefits of ultrasound guidance.