Physical Medicine & Rehabilitation

Physical Medicine & Rehabilitation, Physiatry

With the introduction of an affordable portable ultrasound system capable of ultra high resolution real time dynamic images, musculoskeletal ultrasound is now available to the practicing Physiatrist. Musculoskeletal ultrasound (MSKUS) is a natural extension of the Physiatrist’s clinical evaluation and will improve diagnostic accuracy and guide the treatment of a variety of soft tissue disorders, peripheral nerve injuries and inflammatory disorders. MSKUS is dynamic, safe, and has few technical limitations and no contraindications.

More cost effective and timely than CT or MRI and more sensitive than traditional x-ray, MSKUS is now an essential component of the physical medicine and rehabilitation practice. MSKUS has been found to be at least as accurate as MRI for defining rotator cuff injuries. No longer is it necessary to try to define which abnormality found on an MRI study is the pain generator. The immediate patient feedback during the ultrasound examination can guide an experienced MSK sonographer to correctly identify and correlate the abnormal finding with the patient’s pain complaint. This will help reduce medical costs and improve outcomes by eliminating unnecessary testing and focus the treatment on the real problem.

MSKUS can be ideal for needle guidance for aspiration or injection procedures improving the accuracy and outcomes as well as reducing the pain the patient may experience during injections. By using MSKUS rather than fluoroscopy for needle guidance the radiation exposure is avoided and the cost is drastically reduced. MSKUS allows for advanced procedures such as percutaneous tenotomy, calcific deposit irrigation and intra-articular injections to be performed quickly and cost effectively in the office.

MSKUS of is an exciting technique perfectly suited to the musculoskeletal Physiatrist. Here are just a few of the many possible uses for MSKUS in your Physiatry practice.

Diagnostic :

Joint and soft tissue pain generator, bursitis, RTC pathology, tendinopathy, tendinitis, posterior labral tear, AC joint arthritis, muscle atrophy, epicondylitis, joint effusions, inflammatory arthropathies, cortical erosions, fractures, neuromas, nerve entrapments, split peroneal tendons, subluxing tendons, ligament tears, partial and complete tendon ruptures, ganglions, soft tissue masses, snapping hip syndrome.

Interventional:

Joint injection including deep joints such as the hip, bursa injection, tendon sheath injection, cyst aspiration/ injection, percutaneous tenotomy, calcific deposit irrigation, nerve entrapment injection, anterior/ posterior interosseous nerve injection, nerve blocks.

Thanks Biosound for making a great product, Dr Bruce Myers, Portsmouth NH.