Musculoskeletal ultrasound for imaging in Physiatry

In nearly all office pain management interventions use of ultrasound has superceded fluoroscopy in Physiatry. Fluoroscopy is based on X-ray radiation and thus exposes the patient and physician to the harms 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 – pain generators in chronic pain are predominantly in the soft tissues and not bones. Ultrasound shows and demarcates soft tissue layers well. Thus the now common use of ultrasound for pain management interventions.

As musculoskeletal ultrasound instruments advance their use in Physiatry will increase. However it should be noted that the use of ultrasound for imaging does not guarantee positive clinical outcomes. Rather it’s the choice of medications, skill sets of the physician and interventional techniques applied that principally influence outcomes in pain management.

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