Ultrasound Guided Injections in Orthopedics

Recently, my office has begun utilizing ultrasound for the diagnosis and treatment of various musculoskeletal disorders. There are numerous benefits for the use of ultrasound in orthopedics. For one, ultrasound is a non-invasive exam that allows for a high resolution evaluation in real time. This is a wonderful tool for diagnosis. A second use of ultrasound is for performing guided needle procedures. By using ultrasound for guided injections, we can ensure the exact path of the injection.

What can be diagnosed using ultrasound?

Musculoskeletal ultrasound can be used to evaluate the following:

• Tendons
• Partial and full thickness tears
• Degeneration
• Scar tissue formation
• Ligaments
• Muscles
• Tears
• Soft-tissues
• Masses
• Cysts
• Calcification
• Joints
• Effusions
• Loose bodies
• Hematomas

What procedures are performed?                                  

• Aspiration and/or injection of joints
• Tendon origin injections (i.e. tennis elbow)                           
• Bursa injections and aspirations
• Aspiration of cysts, fluid collections and abscesses
• Lavage and aspiration of tendon calcifications
• Injection of platelet-rich plasma (PRP)

Ultrasound is allowing procedures to be safely performed in the office that historically could not have been treated. For example, we had a patient recently with a painful cyst behind her leg. In the past, we would have had leave the cyst alone because blindly aspirating could increase the risk of damaging surrounding tissues, blood vessels and nerves. With ultrasound, we were able to locate and aspirate the cyst right in the office. Ultrasound allowed us to find the cyst, correctly position the needle and watch the cyst disappear. Musculoskeletal Ultrasound provides physicians with the ability to differentiate between cystic and solid and vascular from non-vascular lesions adding a greater benefit for patient safety.