Thanks to advancing technology the use of ultrasound for diagnostic and image guidance services in musculoskeletal medicine is now being rapidly incorporated into modern physiatric office-based practices.
In many instances this technology has superceded the use of fluoroscopy for image-guidance of many types of injections – and not a minute too soon. Fluoroscopy is based on X-ray radiation and thus exposes the patient and physician to the harm of radiation. Fluoroscopy is expensive as it requires expensive equipment, regular maintenance and check-up and the presence of a radiation technologist. Fluoroscopy does not allow for visualization of soft tissues nor is conducive to soft tissue diagnostic endeavors. The whole of injection therapeutics is based on soft-tissue diagnostics and soft-tissue image guidance ( for nerves, tendons, myofascial tissue, etc.).
In contradistinction to fluoroscopy, musculoskeletal ultrasound provides positioning and diagnostic data on soft-tissue pathology. With such technology one can properly address different tissues and focus the delivery of medicine with much accuracy to targets in proximity to one-another. There is no radiation hazard – or any hazard – from the instrument. The cost is a fraction of fluoroscopy and the logistics of use fluent – all is done in the comfort of the physician’s office and no visit to a surgicenter or operating room is needed.
We have state of the art musculoskeletal ultrasound and use it regularly in the provision of injection therapeutics. Gradually we are incorporating certain diagnostics into our repertoire of musculoskeletal ultrasound as well. We regularly review new publications on the utilization and capabilities of musculoskeletal ultrasound and attend advanced workshops to further our expertise in this most helpful and effective technology now available to modern neuromusculoskeletal office-based practices in physiatry.