When most people hear sonogram or ultrasound, they think someone’s having a baby. But recent advances in ultrasound technology have led to its expanded use in orthopaedics, especially sports medicine.
Ultrasound (US) can be used for both diagnosis and treatment. Almost all soft tissue problems can be imaged with ultrasound. Ultrasound exams can be performed quickly in the office and in the right hands, can be nearly as informative as other imaging tests. Surgeons and radiologists trained in the use of US to examine shoulders have been able to make the diagnosis of a rotator cuff tear with the same accuracy as MRI. You don’t have to worry about claustrophobia or contrast reactions and the test takes no more than 5 minutes to perform. You can also quickly image just about any tendon and get an idea off the amount of damage, tendonitis, or tendinopathy (see later posts about the treatment options that use US).
Even more exciting are the ways we can use US to improve the care we provide to you. Injections are a big part of what we offer to help with your pain and get you back in the game quickly. Cortisone, platelet rich plasma, hyaluronic acid supplements and local anesthetic injections can help reduce pain and inflammation, improve healing, and aid in diagnosis. The most difficult part of an injection (for us – because the most difficult part for you is the big needle jabbed into your joint) is accurately placing the needle where we need it to be. And while you trust that once we decide together that an injection is best for you that we will always put it in the exact right place, that’s harder than it sounds sometimes. In the best trained and most experienced hands, accuracy of injection into the bursa of the shoulder is only about 75%. In the knee its closer to 85%. In the biceps tendon its even lower. So how can we improve those numbers? Of course experience helps – and we perform about 50 injections per week and have been doing so for 10 years, but we feel there is always room for improvement.
Enter the ultrasound machine. We can now watch the needle enter the space that we want to inject on a live video feed from the US probe. The use of US increases the accuracy of a knee or bursa injection to above 97%! That’s pretty close to perfect. And that’s what we are striving for. We have now been using US for all of our injections for almost a full year now and have extensive experience with the machine.
In later posts we’ll talk about the other ways we can use US to both image and treat tendon problems with even newer, more exciting technology!
Call us to see if an Ultrasound guided injection is right for you.