Musculoskeletal Ultrasound (MSKUS)

Most people associate ultrasound cameras with looking at the baby to determine the gender. However an ultrasound camera is also an excellent tool for both diagnosing musculoskeletal disorders and precise needle placement for injection. Ultrasound guidance is a basic requirement for stem cell therapy.

Powerful Tool for Assessment

MRI and CT scans are conventionally thought of as the gold standard for diagnosing such conditions as low back and neck pain, rotator cuff injuries, nerve entrapment, carpal tunnel syndrome, torn ligaments, and other musculoskeletal conditions. The major disadvantages of these techniques are that they are very expensive, they are unappealing to those people who tend toward claustrophobia, and they do not show degeneration or laxity of soft tissues. Ultrasound, on the other hand, is done in the office within minutes and is relatively inexpensive. The exact location of degeneration of tissues (such as in tennis elbow and Achilles tendonitis) can be pinpointed. This allows for precise treatment.

Because it is a motion camera, structures are viewed in real time. This gives the huge advantage of being able to view structures in real time. This is particularly valuable when evaluating impingement syndromes, snapping syndromes, laxity of ligaments causing instability of joints, and muscle and tendon tears that only show up with certain movements.

Precise Needle Placement

Another huge advantage of ultrasound is its use for guidance of injections. You can see the structure you want to inject, you can see the needle tip touch that exact point, and then you can see the fluid infiltrate that structure. Precise needle placement greatly reduces risk and improves outcomes.

Studies have shown that when performing intra-articular injections of the shoulder and hip ‘blind’ (without any type of imaging), orthopedic doctors have a miss rate of around 70%. When injecting under ultrasound, the miss rate is under 5% because the doctor can see the joint, see the needle entering the joint, and see the fluid entering the joint.