Ultrasound Guided Injections
Ultrasound is a painless, non-invasive form of imaging technology that uses sound waves to produce images of structures inside the body including tendons, ligaments, muscles, and nerves. Ultrasound can be used for both diagnostic and potentially therapeutic purposes.
Although ultrasound is very poor at imaging bone, there are several advantages of ultrasound. Some of these advantages include the following:
• Ultrasound provides superior imaging quality of tendons, muscles, and ligaments compared to x-rays.
• Unlike an MRI, an ultrasound exam can be performed during your office visit without any prior authorization from your insurance company or need for scheduling.
• Unlike an MRI which can take more than 30 minutes, an ultrasound exam can be performed in a few moments during your office evaluation.
• Unlike x-rays and MRI which provide still images, an ultrasound is a dynamic process that can evaluate muscles, tendons, and joints during motion. This can be useful when attempting to diagnose the source of painful motion-related snaps and pops.
• Unlike x-rays and MRI, ultrasound does not use radiation and is therefore safer.
Common Uses for Ultrasound as a Diagnostic Tool:
Ultrasound can be used to aid in the diagnosis and evaluation of many orthopedic conditions including the following:
• Biceps tendon instability in the shoulder
• Subacromial bursitis and impingement syndrome
• Quadriceps or patellar tendon ruptures
• Golfers or Tennis elbow
• Evaluation of cysts
• Evaluation of painful snaps and pops
Ultrasound as a Therapeutic Tool:
Using ultrasound as a therapeutic tool is perhaps more important than its role for diagnostic purposes at Phoenix Shoulder and Knee. Ultrasound imaging can be used to aid injections. There are many advantages to using ultrasound to guide the injections (as opposed to not using ultrasound) including the following:
• Increased accuracy
Numerous studies have reported low accuracy when performing injections in and around the shoulder, knee, elbow, and hip without the assistance of image guidance such as ultrasound. Improved accuracy leads to less pain and better clinical results. The greater accuracy of ultrasound-guided injections has been proven in numerous research studies regardless of the physician’s level of experience.
• Increased Safety and the ability to inject or aspirate near potentially dangerous structures
Using ultrasound-guidance allows physicians to be able to place needles adjacent to structures such as blood vessels or nerves that were previously felt to be too dangerous to attempt without the assistance of ultrasound. This can be useful when performing injections near nerves (such as the carpal tunnel), into tendon sheaths (such as the biceps), or draining cysts that may be near large blood vessels (such as popliteal or Baker’s cysts). The direct visualization provided by the ultrasound offers a greater margin of safety for injections in these areas.
Common Uses for Ultrasound as a Therapeutic Tool:
• Injections into the various shoulder compartments including the glenohumeral joint space, the subacromial space, the a.c. joint space, and the biceps
• Aspiration of knee joint effusions
• Aspiration of cysts
• Injections of platelet rich plasma (PRP) directly into pathologic areas
• Needling of calcific tendinitis deposits
• Steroid injections directly into the hip joint. (This procedure previously required equipment found in a hospital setting and had to be scheduled on a separate date.)