Ultrasound scan of elbow: Cubital Tunnel Injection

Best Cubital Tunnel Injection: A Revolutionary Treatment

Cubital tunnel syndrome can be a painful and debilitating condition. It affects the ulnar nerve, which runs through the elbow, causing numbness, tingling, and pain in the arm and hand. For those suffering from this syndrome, finding effective treatment is crucial to regain their quality of life. 

With its distinctive formulation and proven effectiveness, the Sonoscope goes beyond offering mere temporary relief; it paves the way for enduring comfort and enhanced mobility. It can significantly affect everyday tasks and overall well-being, underscoring the importance of effective treatment.

This detailed guide will cover everything you need to know about Sonoscope Cubital tunnel syndrome for pain relief.

Why Is It Important To Understand Cubital Tunnel Syndrome?

Understanding cubital tunnel syndrome is very important because it helps people know what to do if they have symptoms. Cubital tunnel syndrome happens when the ulnar nerve in your elbow gets squeezed or irritated. This nerve runs from your neck down to your hand. It can cause problems like numbness, tingling, or pain in your ring and little fingers, and even make your hand feel weak. Knowing about this condition can help you recognize these symptoms early and get the right treatment before it gets worse.

One reason it is important to understand cubital tunnel syndrome is that it can really affect your daily life. Imagine trying to do your homework, play your favorite video games, or even eat with chopsticks when your hand is numb or hurts. It would make everything harder and less fun. If you know what to look for, you can tell an adult, like your parents or a teacher, so they can help you get to a doctor. The doctor can figure out if you have cubital tunnel syndrome and what you need to do to feel better.

Another reason to understand cubital tunnel syndrome is that early treatment can prevent more serious problems. If the nerve stays squeezed for too long, it can get damaged. This can make it even harder to use your hand. Doctors might suggest different treatments, like wearing a splint to keep your elbow straight, doing special exercises, or in some cases, having surgery. The sooner you start treatment, the better your chances of avoiding long-term problems.

Knowing about cubital tunnel syndrome can also help you avoid things that make it worse. For example, if you spend a lot of time leaning on your elbows, like when you are reading a book or using your computer, it can put extra pressure on the nerve. By understanding this, you can learn to change your habits to protect your elbow. You might take breaks more often, use a pillow to rest your elbows on, or try to sit in a way that doesn’t put pressure on your elbows. These small changes can make a big difference in keeping the nerve healthy.

Hence, understanding this condition is important for everyone, not just adults. Kids can get cubital tunnel syndrome too, especially if they do activities that put a lot of stress on their elbows. By learning about it now, you can take steps to keep your elbows safe and avoid problems in the future.

What Are The Benefits Of Sonoscope For Cubital Tunnel Syndrome?

Cubital tunnel syndrome is a condition that happens when the ulnar nerve in your elbow gets squeezed or pressed. This can make your hand and fingers feel numb or tingly, and it can even make your muscles weak. If you have this problem, doing simple things like holding a cup or opening a jar can become very hard.

Some common treatments include physical therapy, medications, and sometimes surgery. However, there's a new and exciting treatment called Sonoscope that can help with cubital tunnel syndrome.

Sonoscope is a special tool that doctors use to give very accurate injections. It uses ultrasound, which is a type of imaging that lets doctors see inside your body in real time. This means the doctor can see exactly where the needle is going and make sure it goes to the right spot. This is very important because it helps the medicine go exactly where it is needed, which makes the treatment work better.

One of the biggest benefits of Sonoscope is its precision. Because the doctor can see exactly where the needle is going, they can make sure the injection is very accurate. This helps the medicine work better and can make the treatment more effective. It also means there is less risk of damaging other parts of your body, like muscles or blood vessels, during the injection. This makes Sonoscope a very safe option.

Another great thing about Sonoscope is that it is minimally invasive. This means that it doesn't involve big cuts or a lot of recovery time. Surgery can be very painful and take a long time to heal, but Sonoscope injections are much simpler. They are done with a small needle, so the procedure is quick, and you can go home the same day. This also means you can get back to your normal activities faster.

People who have used Sonoscope to treat their cubital tunnel injection have reported very good results. Many patients say they feel less pain and their hand and finger movements improve. This means they can do everyday tasks more easily. Some patients have even said that the treatment helped them avoid surgery, which can be a big relief.

The way Sonoscope works is pretty amazing. The device combines a high-quality ultrasound probe with an injection system. During the procedure, the doctor uses the ultrasound image to guide the needle to the exact spot that needs treatment. This targeted approach helps reduce inflammation and pressure on the ulnar nerve, which causes the symptoms of cubital tunnel injection.

Many patients who have tried Sonoscope are happy with the results. They say the treatment is not very painful and that it helps them feel better quickly. The treatment is also very convenient because it doesn't take a lot of time, and you don't have to stay in the hospital.

Conclusion

Sonoscope’s cubital tunnel injection offers a revolutionary treatment for those suffering from cubital tunnel syndrome. Its non-invasive nature, quick recovery time, and long-lasting relief make it an excellent alternative to traditional treatments. By choosing Sonoscope, patients can look forward to improved quality of life and effective management of their symptoms. If you or someone you know is struggling with cubital tunnel syndrome, consider exploring this innovative treatment option.


hydroistension acid injection : Radiocarpal Joint Pain

Top 10 Causes of Radiocarpal Joint Pain

Are you tired of enduring joint pain that hinders your daily activities? Look no further as we explore the realm of Sonoscope, the leading brand for Radiocarpal Joint pain relief.

Radiocarpal joint pain can severely affect your capacity to complete everyday activities. Situated at the wrist, the radiocarpal joint is vital for a range of movements. Recognizing the sources of discomfort in this joint is essential for treating and controlling it effectively.

When traditional treatments like rest, physical therapy, and medications don't bring relief, injections can be a beneficial choice.  This article examines the primary reasons behind radiocarpal joint pain, offering details on its signs, diagnosis, and available treatment approaches.

What Is The Anatomy Of The Radiocarpal Joint?

The radiocarpal joint, commonly known as the wrist joint, is a very important part of the body that helps us move our hands and perform many daily activities. Understanding its anatomy can help us appreciate how it works and why it sometimes hurts. Let's take a closer look at this fascinating joint.

The radiocarpal joint is located at the wrist, connecting the forearm to the hand. It is made up of two main bones in the forearm: the radius and the ulna. These two bones extend from the elbow down to the wrist. However, only the radius directly connects with the carpal bones of the hand to form the radiocarpal joint.

At the end of the radius, there is a smooth surface that joins with the carpal bones. The carpal bones are a group of small bones that form the base of the hand. There are eight carpal bones arranged in two rows. The radiocarpal joint specifically involves the first row of these carpal bones, which includes the scaphoid, lunate, and triquetrum. These three bones connect with the radius to form the wrist joint.

The radiocarpal joint is a type of synovial joint, which means it has a special fluid called synovial fluid inside it. This fluid helps the joint move smoothly and reduces friction. The joint is also surrounded by a tough, fibrous capsule that holds the bones together and provides stability. Inside this capsule, there is a smooth lining called the synovial membrane, which produces the synovial fluid.

Several ligaments also help support the radiocarpal joint. Ligaments are strong, flexible bands of tissue that connect bones to other bones. In the wrist, these ligaments hold the radius and carpal bones together, ensuring that the joint remains stable while allowing movement.

The muscles and tendons that control these movements are located in the forearm and hand. Tendons are tough, fibrous cords that attach muscles to bones. When the muscles contract, they pull on the tendons, which then move the bones in the wrist. Some of the main muscles involved in wrist movements include the flexor and extensor muscles. The flexor muscles help bend the wrist, while the extensor muscles help straighten it.

What Are The 10 Causes of Radiocarpal Joint Pain?

Here are the top 10 causes of radiocarpal joint pain given below.

Cause 1: Arthritis

Arthritis is a common cause of radiocarpal joint pain. Different types of arthritis can affect the wrist, including osteoarthritis and rheumatoid arthritis. Osteoarthritis results from wear and tear of the joint cartilage, while rheumatoid arthritis is an autoimmune condition causing joint inflammation. Symptoms include pain, swelling, and reduced range of motion.

Cause 2: Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve is compressed as it travels through the carpal tunnel in the wrist. This condition can cause pain, numbness, and tingling in the wrist and hand, particularly affecting the radiocarpal joint. Repetitive hand movements and wrist positioning often contribute to this syndrome.

Cause 3: Tendinitis

Tendinitis is the inflammation of tendons around the radiocarpal joint, often resulting from overuse or repetitive strain. Common symptoms include pain, tenderness, and swelling in the wrist. Treatment typically involves rest, ice, and anti-inflammatory medications.

Cause 4: Wrist Fractures

Fractures in the wrist can directly impact the radiocarpal joint, causing significant pain and limited movement. Wrist fractures may result from falls, sports injuries, or accidents. Proper immobilization and, in some cases, surgery are necessary to ensure proper healing and function restoration.

Cause 5: Ligament Injuries

Ligament injuries in the wrist, such as sprains or tears, can cause severe pain and instability in the radiocarpal joint. These injuries often occur due to sudden impacts or twists. Treatment may involve rest, physical therapy, or surgical intervention, depending on the severity of the injury.

Cause 6: Repetitive Strain Injuries (RSI)

Repetitive strain injuries occur from continuous, repetitive motions that stress the wrist. Activities like typing, playing musical instruments, or certain sports can lead to RSI, causing pain and discomfort in the radiocarpal joint. Preventive measures include ergonomic adjustments and regular breaks during repetitive activities.

Cause 7: Gout

Gout is a type of arthritis caused by the accumulation of uric acid crystals in the joints, including the radiocarpal joint. It leads to sudden, severe pain, swelling, and redness. Treatment for gout involves medications to reduce uric acid levels and manage pain.

Cause 8: Infections

Infections in the wrist joint, though rare, can cause significant pain and inflammation. These infections may result from injuries, surgeries, or spread from other parts of the body. Prompt diagnosis and treatment with antibiotics are crucial to prevent joint damage.

Cause 9: Ganglion Cysts

Ganglion cysts are non-cancerous lumps that often develop along the tendons or joints of the wrists. These cysts can cause pain and interfere with joint movement if they press on nearby nerves. Treatment options include aspiration, where fluid is removed from the cyst, or surgical removal.

Cause 10: Kienbock’s Disease

Kienbock’s disease is a rare condition where the blood supply to one of the small bones in the wrist, the lunate, is interrupted, leading to bone death. This condition causes chronic wrist pain and stiffness. Treatment may involve immobilization, medication, or surgery to restore blood flow and function.

Conclusion

Radiocarpal joint pain can stem from various causes, each requiring specific treatments and preventive measures. Understanding these causes and seeking appropriate medical advice can significantly improve your quality of life. If you experience persistent wrist pain, consult a healthcare provider to explore the best treatment options, including innovative solutions like Sonoscope injections.


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Carpal tunnel syndrome- is steroid injection helpful?

Carpal tunnel syndrome, what is it?

The carpal tunnel is located underneath the wrist crease overlying the wrist joint. The carpal tunnel is a protective tunnel of bone and has a ligament overlying the anatomical structures (Fig. 1). The transverse ligament is a thick ligament very much like a cable tie and keeps all the structures in place.

Carpal tunel graphic

Carpal tunnel syndrome

Many critical structures are tightly packed together within a small tunnel. The carpal tunnel syndrome can be caused by the tunnel becoming strained which can affect the structures running in the carpal tunnel. Nerve tissue is sensitive to small changes in pressure. This can cause nerve irritation and cause symptoms of carpal tunnel syndrome. The main symptoms are pain and numbness in the distribution of the median nerve (see Fig. 2). Compression of the nerve can also cause significant weakness of the musculature if more advanced.

If left untreated compression of the median nerve can cause lasting nerve damage. This can lead to permanent weakness and numbness and pain in the hand. It is therefore important to diagnose this problem early on and to treat it promptly.

We be discussing treatment options and pose the question what conservative treatments are helpful and especially injection therapy. So we can hopefully answer the question in the title of this article: Carpal tunnel injection- is it helpful?

 

Causes of carpal tunnel syndrome

There is still a lot unknown about carpal tunnel syndrome. We know that there are several factors that play a role in developing carpal tunnel syndrome.Physical repetitive activity could be a factor. There are other factors such as diabetes, hormonal changes such as during pregnancy and an underactive thyroid. These can all be contributing factors. A direct injury to the wrist can also cause damage to the median nerve the wrist joint. This in turn can also cause problems with the median nerve.

Treatment of carpal tunnel syndrome

The correct treatment of carpal tunnel syndrome depends on the accuracy of the diagnosis. The most important way to evaluate the carpal tunnel is simply by doing a thorough physical assessment. The Sonoscope ultrasound guided injection clinic has experts with many years of experience. They have successfully managed many hundreds of people with carpal tunnel syndrome.

The use of diagnostic ultrasound provides another level of information and often confirms the diagnosis made by physical examination. Ultrasoujd can detect nerve caliber changes along the nerve path which is commonly found in Carpal tunnel syndrome and can help to confirm the diagnosis.

If left untreated compression of the median nerve can cause lasting nerve damage. This can lead to permanent weakness and numbness and pain in the hand. It is therefore important to diagnose this problem early on and to treat it promptly.

Ultrasound guided injection

Carpal tunnel injection- is it helpful?

We would always advocate for this procedure to be done under ultrasound guidance. This will improve the accuracy of the procedure as well as the safety. Only those with a high level of diagnostic ultrasound and ultrasound guided injection expertise and who perform a significant number of these injections regularly should be performing ultrasound-guided injection for carpal tunnel syndrome as it is technically demanding.

Evidence:

Eslamian (et al, 2017) comparing both landmark guided with ultrasound guided injections concludes: that the evidence Both US-guided and LM-guided steroid injections were effective in reducing the symptoms, improving the function and electrodiagnostic findings of CTS. Although there was better symptomatic improvement with US-guided injections.

Safety:

In the hands of a highly trained expert in diagnostic ultrasound and ultrasound guided procedures the needle tip can be accurately monitored and steered to inject in the exact accurate location. This will reduce the risk of inadvertent nerve or vascular injury.

Comfort:

Accuracy and needle monitoring will also result in significantly less discomfort as it will allow the operator to avoid as much as possible pain sensitive structures.

 

Carpal tunnel decompression surgery: 

If the numbness and pain and or weakness don’t improve with other treatments, then surgery might be required. The surgery, known as carpal tunnel release or decompression surgery relieves pain by reducing the pressure on the median nerve. 

References:

Recovery from the surgery is usually less than a month, although it may take longer to get all the feeling back in your hand, especially if you’ve had the condition for a long time. 

Eslamian, F., Eftekharsadat, B., Babaei-Ghazani, A., Jahanjoo, F. and Zeinali, M., 2017. A randomized prospective comparison of ultrasound-guided and landmark-guided steroid injections for carpal tunnel syndrome. Journal of Clinical Neurophysiology34(2), pp.107-113.

References:

Eslamian, F., Eftekharsadat, B., Babaei-Ghazani, A., Jahanjoo, F. and Zeinali, M., 2017. A randomized prospective comparison of ultrasound-guided and landmark-guided steroid injections for carpal tunnel syndrome. Journal of Clinical Neurophysiology34(2), pp.107-113.


Shoulder skeleton image

What is physiotherapy?

What is physiotherapy?

Physiotherapy as described by World Physiotherapy is a health care profession concerned with human function and movement and maximising physical potential. It is concerned with identifying and maximising quality of life and movement potential within the spheres of promotion, prevention, treatment/intervention, habilitation and rehabilitation[1]. It uses physical approaches to promote, maintain and restore physical, psychological and social well-being, taking into account variations in health status.  It is science-based, committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery.  The exercise of clinical judgement and informed interpretation is at its core[2].

 

What do physiotherapists do?

Physiotherapy is a healthcare profession that provides services to people of all ages, from newborns to the elderly. Physiotherapists help people who are recovering from an injury or illness, or who have a long-term health condition, such as arthritis.

Physiotherapists work in hospitals, clinics, community health centres, private practices and people’s homes. They may also work in industrial and sporting settings.

Physiotherapy addresses the illnesses or injuries that limit a person’s abilities to move and perform functional activities in their daily lives.[7] Physiotherpists take an individual’s history and physical examination to arrive at a diagnosis and establish a management plan and, when necessary, incorporate the results of laboratory and imaging studies like X-rays, CT-scan, or MRI findings. Electrodiagnostic testing (e.g., electromyograms and nerve conduction velocity testing) may also be used.[8]

 

What are the benefits of physiotherapy?

Physiotherapy can benefit people of all ages. It helps to restore movement and function when someone is affected by injury, illness or disability.

Physiotherapy can:

  • Alleviate pain
  • Increase mobility
  • Improve quality of life

 

How can physiotherapy help me?

Physiotherapy is a branch of medicine that deals with the assessment, diagnosis, and treatment of physical and functional impairments. Physiotherapy can help you by improving your mobility, relieving pain, and preventing or managing injuries.

 

What conditions can physiotherapy help?

Physiotherapy can help a range of conditions, from everyday aches and pains, to more complex long-term conditions. It can also help you prevent injuries from happening in the first place.

Some of the conditions physiotherapy can help with are:

-joint and muscle pain, including back pain and neck pain
-arthritis
-frozen shoulder
-tendonitis
-sprains and strains
-whiplash
-headaches caused by muscle tension

 

How does physiotherapy help?

Physiotherapy is a health care profession that provides services to individuals and populations to develop, maintain and restore maximum movement, function and wellbeing throughout the lifespan. It involves the assessment, diagnosis, treatment and prevention of musculoskeletal, neurological, cardiovascular and respiratory conditions.

 

What can I expect from physiotherapy?

Physiotherapy is a rehabilitation profession that uses a range of techniques to alleviate pain, promote movement and restore function. The aim of physiotherapy is to help you live your life to the fullest potential.

 

What will happen during my first visit?

At your first visit, the physiotherapist will take a thorough medical history and perform a physical examination. They may also order tests, including X-rays, MRIs, and blood tests. The physiotherapist will use this information to develop a treatment plan specifically for you.

 

How often will I need to see a physiotherapist?

This will depend on the severity and nature of your injury or condition. In some cases, you may only need to see a physiotherapist once or twice. In other cases, you may need to see a physiotherapist on a regular basis for several months.

 

How can I find a physiotherapist?

To practise as a physiotherapist in the UK you must be registered with the Health and Care Professions Council (HCPC), which is the regulatory body for physiotherapists and some other allied health professions (AHPs).

Your GP might refer you via the NHS to see a physiotherapist. Privately you might find a physiotherapist through recommendation or via an internet search for local physiotherapists. Please make sure that you find out if your physiotherapist is fully trained and competent by checking their status on the HCPC register check here

To become registered with the HCPC as a physiotherapist you must meet the HCPC criteria. Physiotherapists need to meet three sets of standards (please see click the links to see each set of standards): Standards of conduct, performance and ethics,  Standards of proficiency for physiotherapists,  Standards of continuing professional development.

Physiotherapists also need to have professional liability insurance (PLI) in order to be registered with the HCPC.

How do I know if a physiotherapist is right for me?

Before you book an appointment with a physiotherapist, it’s important to do your research to make sure they’re the right fit for you.

A good place to start is by asking for recommendations from friends, family, or your primary care doctor. Once you have a few names, you can check their credentials  (please see above re professional registration)

You can also look up reviews online, or contact the physiotherapist directly to ask about their experience and treatment methods. When you meet with them, be sure to ask plenty of questions so that you feel comfortable with their approach.

Once you’ve found a physiotherapist that you trust, they will be able to assess your condition and develop a treatment plan that is tailored to your needs.

What should I look for in a physiotherapist?

There are many things to consider when looking for a physiotherapist. Below are some factors you may want to keep in mind:

  • What is the physiotherapist’s education and training?
  • How long has the physiotherapist been in practice?
  • Is the physiotherapist registered with the HCPC?
  • What is the physiotherapist’s approach to treatment?
  • Does the physiotherapist have experience treating patients with conditions similar to yours?
  • Does the physiotherapist use modalities that you are comfortable with?
  • Is the physiotherapist’s office conveniently located and easy to get to?
  • Is the staff friendly and helpful?
  • Do you feel comfortable communicating with the physiotherapist?

 

What if regular physiotherapy is unable to help me?

If  physiotherapy alone isn’t enough to improve your problem then seeing an advanced practice physiotherapist can be helpful. Usually regular physiotherapists either work with or are aware of specialist physiotherapists with an extended skill set. They are usually referred to as Advanced PracticePphysiotherapists (APPs).

Often times in musculoskeletal physiotherapy they have added skills and competencies. So they may be trained as: Injection therapists, sonographers, or prescribers of medicines. A highly trained Advanced Practice Physiotherapist  might be able to help where regular physiotherapy has stalled and where diagnostic imaging is required as well as potential injection therapy to manage the problem.

Advanced Practice Physiotherapy

Robert Mast who is the owner and clinical director of Sonoscope ultrasound guided injections he is a highly trained Advanced Practice Physiotherapist (APP) and is a (CASE accredited) qualified expert in diagnostic ultrasound as well as an independent prescriber of medicines and an experienced injector. He has worked in the NHS for many years in specialist MSK services managing complex musculoskeletal conditions. He is also employed as a specialist MSK sonographer in a busy NHS radiology performing many diagnostic ultrasound scans and ultrasound guided interventions for those with musculoskeletal injuries and conditions . He is also an experienced educator and runs university based (Brunel University) diagnostic ultrasound as well as ultrasound guided injections programs. Please click Robert Mast to get in touch with  and he will get back to you as soon as possible.

Secondary care specialists

In certain scenarios medical input is required.

For example: an Orthopaedic consultant is needed when Orthopaedic surgery is considered maybe to repair a bone, ligament of tendon or to replace a joint (for example a  hip or knee joint). In case of an inflammatory arthitis is suspected then referral to a rheumatologist would be required.  In case of a neurological problem a neurologist opinion might be necessary etc.


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What is Advanced Practice Physiotherapy?

What is Advanced Practice Physiotherapy?

Advanced practice (AP) enables physiotherapists to incorporate advanced level skills and knowledge within their physiotherapy practice.
These Advanced Practice Physiotherapists (APPs) use their skills to address complex decision-making processes in the management
of patients with a range of presentations in both intervention and preventive care. APPs have completed an advanced programme of
studies beyond their initial physiotherapy training which will include the development of a range of skills and knowledge such as for example independent
prescribing.

What does this mean in practice?

  • The advanced practice physio will use a combination of advanced skills, knowledge and attitudes which enables him to address complex problems and manage risk in unpredictable contexts
  • The advanced practice physiotherapist will us advanced critical thinking todeliver care to patients with complex needs safely and competently.
  • The advanced practice physiotherapist has the ability to recognise and manage unfamiliar presentations, recognising where a clinical presentation
    is outside an individual’s scope and take appropriate action.

What can I expect from Sonoscope?

At Sonoscope we are committed to provide the highest level of care for our patients. To deliver the One-Stop-Clinic experience the levels of skills required by the practioner have to be of the highest level of advanced practice physiotherapy

Robert Mast who is the owner and clinical director of Sonoscope ultrasound guided injections is a a highly trained and (CASE accredited) qualified expert in diagnostic ultrasound as well as an independent prescriber of medicines and an experienced injector. He has worked in the NHS for many years in specialist MSK services managing complex musculoskeletal conditions. He is also employed as a specialist MSK sonographer in a busy NHS radiology department performing many diagnostic ultrasound scans and ultrasound guided interventions for those with musculoskeletal injuries and conditions. In addition to that he is an experienced educator and runs university based (Brunel University) diagnostic ultrasound as well as ultrasound guided injections programs.

You can rest assured that the care provided is the complete integrated package .

  • You will receive a clinical assessment (taking the history and carrying out an expert physical assessment)
  • You will then have a diagnostic ultrasound scan
  • If indicated you may then also have an ultrasound guided injection

This will all be done within the one session


ultrasound scan for shoulder pain

Steroid injection for shoulder bursitis

Steroid Injection for shoulder bursitis

What is shoulder bursitis? 

Bursae (plural) are potential fluid-filled sacs that are part of the skeletal system. They cushion the space between bones and connective tissue, allowing tendons, muscle and bone to move together. 

In the shoulder, the subacromial bursae cushion the area between the rotator cuff tendons and the acromion (the highest point of the shoulder blade or scapula). Bursae allow the tendons and bones to glide without friction when you move and lift your arms. 

Injuries or overuse of the shoulder can cause swelling of the bursae. Often the term subacromial bursitis is used to refer to bursitis that affects the shoulder. 

Symptoms:

You may have bursitis if a part of your body, particularly areas close to a joint or directly over a bone, is red or swollen, hot and sore, painful – usually with a dull, aching pain . The area is sensitive and painful if you try to press on or move it, If the bursa is just under your skin, you may also be able to see its outline, because of the swelling inside it. 

Are there different types of bursitis? 

Chronic: 

Injuries or repetitive activities can lead to irritation of the subacromial bursa causing shoulder bursitis. Significant structural injuries such as damaged tendons or irregular or damaged bone may also contribute to irritation of the subacromial bursa leading to recurrent/chronic bursitis. 

Acute: 

This is usually a bursitis of a sudden onset often due to a trauma 

Septic: 

In very unusual and rare cases bursa can become infected which can be related to a skin piercing injury. Usually, the shoulder feels hot and swollen as well as red the pain can be severe 

Common locations of bursitis: 

The most common locations for bursitis are in the shoulder, elbow and hip. However, it can also occur in the knee, heel and the base of the big toe. Bursitis often occurs near            joints that perform frequent repetitive motion.   

Causes: 

Bursitis is caused by inflammation of small fluid pads that overlie areas of strain and stress such as tendons and bones. The normal situation the small pads actually help to make normal movements run very smooth and without any pain and discomfort. However when they become inflamed sometimes due to increased irritation and local stress on the body part they can swell up and become very painful and causing significant impact on normal function. 

How would you know if you have a bursitis?

When as mentioned above you have inflammation of the bursa the bursa might be swollen and painful. This can have a significant impact on the movement of the body part. Pain from the bursitis is usually a dull ache. It can be significantly red and swollen as well. 

Some inflammatory conditions such as rheumatoid arthritis can cause bursitis and another inflammatory conditions such as gout can cause crystals in or around the joints that can cause bursitis as well. 

Often the area where there is strain on tendons such as around the knee the shoulder or the hip can result in bursitis. The underlying source here is usually a tendon which might need treatment which can improve the bursitis. 

 

What treatment can be helpful 

If the pain is quite acute than ice packs on the affected area can be very helpful. Cushioning of the affected area can be helpful. This can be her a foam pad for example or a specific support with padding. 

Physiotherapy can be helpful in particular to address the underlying issues causing the bursitis. Specific exercises and conditioning can help to improve tendon function and reduce bursitis as a result.  

Medication can in some cases be helpful. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can be helpful to reduce the most acute pain 

 

What to do if the symptoms do not improve? 

If you have a temperature then do see your GP. If the skin overlying the bursa has been broken then also see your GP. 

If symptoms do not improve but do not have the features as mentioned above (signs of infection) then assessment by a practitioner with specialist musculoskeletal assessment skills would help to diagnose the problem. Examination of the body part should identify the exact problem. A further ultrasound scan would confirm the findings. Sometimes aspiration of the fluid is necessary usually with steroid injection to bring down the local inflammation. 

 

A One-Stop clinic to both diagnose and treat bursitis: 

The fastest and most effective way to manage this problem if the above management strategies have not been effective would be to be seen in a one-stop clinic. 

The Sonoscope diagnostic ultrasound and ultrasound guided injection clinic offers an expert assessment of the body part involved. Diagnostic ultrasound then follows to confirm the diagnosis and following that and after discussion and if appropriate potentially a steroid injection and/or aspiration can be carried out. This would all be done within the one session without the need for any wait and without the need for any extra expenses. 

 

Diagnostic ultrasound and ultrasound guided injections  

When clinical examination reveals that this is a bursitis then ultrasound can help to confirm it and ultrasound will also allow an appropriately skilled specialist to directly target the bursitis with very specific an accurate needle placement to administer the steroid pinpoint accurate in the correct structure. 

 

What is the benefit of an ultrasound guided injection? 

The traditional way in which steroid injections are administered is through landmark guidance, which means using known landmarks to guide needle insertion. To increase accuracy injections are increasingly administered under ultrasound guidance. 

Improved accuracy can reduce the chance of inadvertent needle placement in a neurovascular structure such as an artery or a nerve. This can help to avoid any potential complications. Also increased accuracy of ultrasound guided vs landmark guided injection can improve the outcome of the injection which has been demonstrated in several studies which has been reported by Daniels et al (2018) in their review of the evidence. 

The evidence suggest that ultrasound guidance has better outcomes for the: glenohumeral joint, subacromial bursa and biceps tendon. This was also found by several studies involving the hip and knee. There is evidence that for some conditions more accurate needle placement leads to faster benefit and better pain relief (Sibbitt, 2012). 

 

 

References:

Daniels, E.W., Cole, D., Jacobs, B. and Phillips, S.F., 2018. Existing evidence on ultrasound-guided injections in sports medicine. Orthopaedic journal of sports medicine, 6(2), p.2325967118756576. 

Sibbitt WL Jr, Kettwich LG, Band PA, et al. Does ultrasound guidance improve the outcomes of arthrocentesis and corticosteroid injection of the knee? Scand J Rheumatol. 2012;41:66-72 


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What is an ultrasound guided injection?

What is an ultrasound guided injection? 

Until recently in most cases injections for musculoskeletal conditions (joints, tendons, ligaments muscles) have been done without direct vision of the needle and instead have been carried out based on our knowledge of the anatomy of the structure that we are injecting. In injecting based on our knowledge rather than directly visualising the structures that we are injecting is called: landmark guided or unguided injections. 

Some GPs, sports physicians, rheumatologists, orthopaedic specialists, and Advanced Practice Physiotherapists have been carrying out landmark guided injections for many years. 

However accurately delivering an injection in for example, a tendon sheath or in a joint space without direct visualisation is quite difficult. This is why more clinicians have started using ultrasound guidance to target the injections accurately. 

 

What are the main benefits of ultrasound guided injections for patients? 

  • Studies have shown that ultrasound guidance reduce the risks  
  • Reduced overall side effects 
  • Better patient comfort 
  • Better patient satisfaction 
  • Significantly more accurate injection with all injection procedures 
  • Improved outcomes. 

 

How is an ultrasound guided injection done? 

Ultrasound-guided injections should be done in a clean environment with the use of sterile ultrasound gel which is placed on the skin. The ultrasound probe is placed on the gel allowing the operator to see the target structure. The tip of the needle is then carefully advanced whilst monitoring it. The tip of the needle is then placed exactly in the target structure. Once we are satisfied with the accuracy of the needle placement the substance in the syringe (steroid, local anaesthetic and or Hyaluronic acid) can be injected. 

 

 

Why do I need an ultrasound guided injection? 

Pain from joints, ligaments and tendons can affect your quality of life and prevent you from doing normal day to day activities. If symptoms do not respond to conservative treatments (rest, physiotherapy) then an injection of local anaesthetic and steroid can be used to provide pain relief. 

 

Who carries out the ultrasound and injection? 

The examination will be performed by a practitioner specialised in musculoskeletal problems (such as a specialist physiotherapist a specialist doctor or a radiologist). 

It can take many years to learn how to do an ultrasound injection. As ultrasound guided injections are a difficult skill to master it is important that you find a practitioner who has excellent skills. Those with high levels of skills often are the ones teaching other practitioners to become competent in ultrasound guided injections.  

It is important to be able to trust the degree of skill of your practitioner as the use of diagnostic ultrasound and ultrasound guided injections in the UK happens without clearly enforced regulation. This is why at Sonoscope injections are carried out by a practitioner who delivers 1000s of injections per year and who is an experienced lecturer and teacher of ultrasound guided injections both privately and through university (Brunel). 

How does it feel to have an injection of local anaesthetic/steroid medication? 

To perform the scan a small amount of gel is applied to the skin surface in the area being examined. The skin at the site of injection will be cleaned using an antiseptic solution. 

A needle will be put into the area to be treated and the local anaesthetic and/or steroid will be injected. You may feel some pushing as the needle goes in and it will feel heavy/tight as the medication is injected.  

You may be asked to wait fora short while after the injection to make sure that you do not have a reaction to the medication used. 

 

Is an ultrasound guided injection better than an unguided injection? 

A recent Systematic Review and Meta-analysis from Deng et. al (2022) Compared the effectiveness and safety of ultrasound-guided versus anatomic landmark–guided corticosteroid injection for the treatment of subacromial impingement syndrome. 

Another recent Systematic review and meta-analysis (ElMeligie, 2022) on the effectiveness of ultrasound-guided versus landmark corticosteroid injection in the treatment of shoulder pain US-guided CS injections showed significant improvement in pain and functional scores (VAS, shoulder functional scores, and shoulder abduction degree) but no difference in disability scores compared with landmark injections.  

A review of the existing evidence on ultrasound guided injections (Deng, 2018) summarises: “Given the improvements in accuracy, ultrasound-guided injections certainly have a role for deeper anatomic structures, for injecting targets that are close to large vascular structures, and for patients in whom nonguided injections have failed”. 

Conclusions:  

Ultrasound guided injections are more accurate than unguided injections. From a safety perspective alone, they should be done in areas with large neurovascular structures and in patients in whom landmark guided injections have failed. 

A recent systematic review found that ultrasound-guided injection of corticosteroids is potentially superior to anatomic landmark–guided injection in improving the clinical symptoms of subacromial impingement syndrome; however, these findings should be interpreted with some caution as the quality of evidence was rated as moderate to low. 

 

Daniels, E.W., Cole, D., Jacobs, B. and Phillips, S.F., 2018. Existing evidence on ultrasound-guided injections in sports medicine. Orthopaedic journal of sports medicine, 6(2), p.2325967118756576. 

Deng, X., Zhu, S., Li, D., Luo, Y., Zhang, X., Tan, Y., Li, J. and He, X., 2022. Effectiveness of Ultrasound-Guided Versus Anatomic Landmark–Guided Corticosteroid Injection on Pain, Physical Function, and Safety in Patients with Subacromial Impingement Syndrome: A Systematic Review and Meta-analysis. American Journal of Physical Medicine & Rehabilitation, 101(12), pp.1087-1098. 

ElMeligie, M.M., Allam, N.M., Yehia, R.M. and Ashour, A.A., 2022. Systematic review and meta-analysis on the effectiveness of ultrasound-guided versus landmark corticosteroid injection in the treatment of shoulder pain: an update. Journal of Ultrasound, pp.1-12. 


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Cortisone Injections for Osteoarthritis

Relieving joint pain caused by arthritis is the most common reason people are coming to our clinic to have an ultrasound-guided injection. Unfortunately, arthritis and its variants of osteoarthritis and rheumatoid arthritis will eventually affect everyone.

What is arthritis?

The term arthritis literally means inflammation or swelling of the joints. According to the Arthritis Foundation, arthritis is a general term that is used to describe over 100 conditions that affect over 8.5M people in the U.K. These conditions have similar symptoms of pain, swelling, and stiffness of the joints and surrounding areas. The two most commonly diagnosed types of arthritis are osteoarthritis and rheumatoid arthritis.

What is Osteoarthritis?

Osteoarthritis, the most common form of arthritis, is degenerative arthritis. Osteoarthritis commonly affects portions of the wrists, ankles, fingers, and toes, as well as the knees, hips, neck, and lower spine.

The arthritic pain described by osteoarthritis patients includes morning stiffness and stiffness following the inactivity of the affected joint. This stiffness rarely lasts for more than 30 minutes. As osteoarthritis progresses, patients report arthritic pain with movement of the joint and resolution of pain upon resting the joint. In advanced disease, patients report pain at rest and pain that awakens them from sleep.

What is rheumatoid Arthritis?

Rheumatoid arthritis, the second most common form of arthritis, is the chronic swelling and inflammation of the joints. The hallmark rheumatoid arthritis symptom is pannus-a swelling and overgrowth of rough tissue (called granular tissue) over the smooth connective tissue that surrounds the area around and between the bones and joints. Although some cases of rheumatoid arthritis are mild, this type of arthritis is often chronic and progressive and leads to deformities and disability.

What are the risk factors and causes of arthritis?

Although researchers have been searching for the cause of arthritis for decades, the cause of arthritis remains unknown. There are three promising theories about the cause of arthritis. These include:

  • Genetic or hereditary factors
  • Immune system abnormalities or autoimmune disease
  • A persistent or triggering infection.

Because more women have arthritis than men, some scientists believe there is a hormonal component to the disease as well.

Other arthritis risk factors are:

  • Age: With the exception of juvenile rheumatoid arthritis, arthritis symptoms often begin after age 40.
  • Gender: Women are at higher risk of arthritis. Of the 21 million Americans with osteoarthritis, 16 million of them are women. Other forms of arthritis, including rheumatoid arthritis, lupus and fibromyalgia, occur more often in women than in men. Men have a higher risk of gout (another common arthritis), and they experience osteoarthritis in greater numbers after age 55.
  • Weight: As few as 10 extra pounds can translate into a higher risk for arthritis, especially in weight-bearing joints like the knees. This increased weight places more pressure on joints and causes the cushioning layer between bones in a joint (cartilage) to break down.
  • Past injuries: A severe joint injury, such as a knee injury that damages cartilage, can add to the overall risk of arthritis.
  • Ethnicity: Ethnic background affects the risk of arthritis. For example, 25% of Caucasians carry the genetic marker for rheumatoid arthritis compared to 10% of African Americans.

What are the symptoms of arthritis?

Because there are 100 conditions* that fall under the term arthritis, it would be difficult to list the symptoms of all of them. However, many of the conditions share similar symptoms. Rheumatoid arthritis symptom list:

  • Gradual onset
  • Weakness, fatigue, and loss of appetite (anorexia)
  • Joint swelling, tenderness, and loss of motion, especially in the wrists, ankles, and fingers
  • Dislocations and joint contractures
  • Chronic inflammation of tendons
  • Possible tendon rupture
  • Rheumatoid nodules over bony areas such as the elbow and wrist.
  • Enlarged spleen
  • Pericarditis (inflammation of the heart wall), and vasculitis (inflammation of the blood vessels)

Osteoarthritis symptom list:

    • Stiffness, pain, and a noisy grating of the joints (crepitus)
    • Joint tenderness, swelling
    • Decreased range of motion
    • Crepitus with motion
    • Bony overgrowths
    • Pain with movement
    • Finger joint involvement leads to the development of nodular swellings.

How is arthritis diagnosed or evaluated?

It is important to see a doctor to be diagnosed properly. Because there are so many types of arthritis, it may take some time to get the correct arthritis diagnosis. Successful diagnosis depends on patient history, symptoms, blood tests, physical examination, and X-rays or radiographic studies. There are no definitive laboratory tests for osteo or degenerative arthritis. Blood work for osteoarthritis is usually normal or inconclusive. A blood test for rheumatoid factor, an autoantibody found in the blood of people with rheumatoid arthritis, can help with a diagnosis of rheumatoid arthritis. X-rays can help with an arthritis diagnosis. An X-ray of an arthritic joint will show joint space narrowing, new and abnormal bone formation, and abnormal, dense tissue growth.

Because many types of arthritis develop slowly, a doctor may suspect one kind of arthritis before other symptoms make the diagnosis clear. Patients should develop a rapport with their doctors and keep a diary of arthritis symptoms to help with diagnosis.

What are the treatments and drugs to treat arthritis?

The goals of arthritis treatment are simple:

  • Relief arthritis pain
  • Minimize joint stiffness
  • Reduce inflammation
  • Preserve muscle and joint function
  • Maintain a normal lifestyle
  • Minimize side effects of arthritis medication.

A basic common sense approach achieves these goals for a majority of patients. Although this approach is not an arthritis cure, it helps patients maintain their quality of life. This arthritis treatment approach consists of

  • adequate rest
  • anti-inflammatory therapy
  • physical therapy to maintain joint function
  • drug therapy to slow the progression of the disease (in some patients).

One of the most important aspects of arthritis relief is the control of inflammation and pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) help control these symptoms. There are several types of these arthritis medicines. Some of these medicines are safer to use than others.

NSAIDs include salicylates, traditional NSAIDs and COX-2 inhibitors. Aspirin is a salicylate. Traditional NSAIDs are medicines like over-the-counter Motrin, Advil, and other ibuprofen-containing brands and Aleve and other naproxen/naproxen sodium-containing brands. Other drugs in this NSAID class include ketoprofen, flurbiprofen, oxaprozin, nabumetone, tolmetin, indomethacin, sulindac, piroxicam, diclofenac, diflunisal, and etodolac. Aspirin and NSAIDs can cause GI upset, bleeding and ulcers in some patients.

COX-2 inhibitors are newer agents which bind only to COX-2 receptors. COX-2 inhibitors are less likely to cause GI symptoms than traditional NSAIDs. However, COX-2 inhibitors may not be safe choices for all patients. Recently, Vioxx, a popular COX-2 inhibitor, was removed from the market due to increased risks of stroke and heart attack with long-term use. Another COX-2 inhibitor, Bextra, may cause similar side effects. Celebrex, a third COX-2 inhibitor, may be a safer alternative.

It is important to remember that these drugs do not modify the progression of the disease but simply help with pain and inflammation, which can significantly improve the patient’s quality of life.

Other types of arthritis medication are disease-modifying antirheumatic drugs (DMARDs) such as hydroxychloroquine, gold, penicillamine, the immunosuppressive agent methotrexate, and azathioprine. These drugs can help slow the progress of the disease. Because these drugs have severe side effects for some patients, it is important that the patient be followed closely by their physician.

Steroid injections

Sonoscope offers injections of a long-acting steroid that may be given directly into a particularly painful joint, especially the knee or thumb. The injection often starts to work within a day or so and may improve pain for several weeks or months. Steroid injections are mainly used for very painful osteoarthritis or for sudden, severe pain caused by crystals in the joint.

How is cortisone injection administered?

Cortisone injections are most commonly given into joints to provide pain relief. They can also be given into tendons near the joint (tender points). The cortisone is injected directly into the painful joint with a needle and syringe. Ultrasound may be used to guide the needle into the correct position.

You will usually have the injection while you’re awake, although you may be given a sedative first if you’re anxious. The skin over the injection site is numbed with a local anaesthetic before the cortisone is injected.

Cortisone injections usually take a few seconds to administer. You will usually be able to go home soon after having the injection.

Conclusion

No one arthritis medicine’s best for all patients. Each patient responds differently to each medication. Some doctors prescribe an alternative arthritis remedy such as acupuncture to help control pain. In a recent study, acupuncture worked better than arthritis medication for the control of the pain and swelling of osteoarthritis of the knee.

Regular exercise and appointments with a physical therapist can help preserve a range of motion for arthritis patients and delay disability.

Other aspects of arthritis treatment can include simple interventions such as the local application of heat or ice, periods of rest at selected times during the day, exercise to maintain joint motion and muscle power, and reduction of weight on painful joints by the use of canes or crutches. Patients also need patient education and emotional support. Surgical procedures may be necessary in patients with severe hip or knee involvement or spinal nerve compression.

 

 

Sources:

Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: randomized controlled trial. British Medical Journal. 18 November 2004; 329: 1216-9.

Arnett, FC. Rheumatoid Arthritis. IN: Cecil Textbook of Medicine, 21st ed. Philadelphia, PA: W. B. Saunders Company; 2000: 1492 – 1499.

Arthritis Foundation. What is Arthritis? Available at: http://www.arthritis.org/resources/gettingstarted/what_is_arthritis.asp.
Accessed November 18, 2004.

Arthritis Foundation. Arthritis. What Are The Risks? Available at:
http://www.arthritisfoundation.org/conditions/JointHealth/Risks.asp.
Accessed November 19, 2004.

Bathon, JM and Ling, SM. Osteoarthritis. IN: Rakel, MD. Textbook of Family Practice, 6th ed. Philadelphia, PA: W. B. Saunders Company; 2002: 1044-1048.

Mercier, LR. Arthritis, Rheumatoid. IN: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2005 ed. St. Louis, MO: Mosby, Inc; 2005: 89.

Mercier, LR. Osteoarthritis. IN: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2005 ed. St. Louis, MO: Mosby, Inc; 2005: 578.

Stedman, TL. Stedman’s medical dictionary. 26th ed. Baltimore, MD: Williams & Wilkins; 1995: 149.


Ultrasound scan of elbow: Cubital Tunnel Injection

What is a Musculoskeletal Ultrasound

If you’re looking for a non-invasive way to get a detailed look at your musculoskeletal system, ultrasound is a great option. This imaging modality uses high-frequency sound waves to produce images of the inside of your body, and it can be used to evaluate a variety of conditions affecting the muscles, tendons, and joints. MSK ultrasound can also be used to accurately guide steroid injections in the joints.

What is musculoskeletal ultrasound?

Musculoskeletal ultrasound is a diagnostic imaging technique that uses sound waves to produce images of the bones, joints, and soft tissues such as ( muscles, tendons, ligaments, nerves etc) of the body. It is used to evaluate a wide variety of conditions, from sports injuries to arthritis.

While X-rays and MRI (magnetic resonance imaging) are also used to image the musculoskeletal system, ultrasound has several advantages. It is non-invasive (no needles or injections are required), does not use ionizing radiation (so it is safer for children and pregnant women), and can be performed on an outpatient basis. In addition, ultrasound images can be acquired in real time, which means that the examination can be tailored to the specific condition being evaluated.

 

How can musculoskeletal ultrasound help diagnose conditions?

Musculoskeletal ultrasound can help diagnose a wide variety of conditions, including:

-Tendinitis
-Bursitis
-Arthritis
-Dislocations
-Muscle tears
-Ligament tears
-Fractures

What are some of the benefits of musculoskeletal ultrasound?

Musculoskeletal ultrasound (MSK ultrasound) is a type of diagnostic imaging that uses high-frequency sound waves to produce detailed images of the joints, muscles, tendons, and other soft tissues.

MSK ultrasound is often used to evaluate problems such as joint pain, muscle pain, or tendonitis. It can also be used to guide needle biopsies and steroid injections.

MSK ultrasound is generally safe and does not use ionizing radiation ( unlike X-rays or CT scans). It is also relatively inexpensive and can be performed on an outpatient basis.

Some of the benefits of MSK ultrasound include:
-It is noninvasive and does not use ionizing radiation.
-It is relatively inexpensive.
-It can be performed on an outpatient basis.
-It can provide detailed images of the joints, muscles, tendons, and other soft tissues.

How is musculoskeletal ultrasound used to treat conditions?

Musculoskeletal ultrasound is used to diagnose and treat a variety of musculoskeletal conditions. The ultrasound waves can help to identify problems with tendons, ligaments, muscles, and joints. The ultrasound waves can also be used to deliver therapeutic treatments such as pain relief or physical therapy.

What are the risks associated with musculoskeletal ultrasound?

Musculoskeletal ultrasound is a safe and effective imaging modality. There are no known risks associated with the use of ultrasound.

What are the side effects of musculoskeletal ultrasound?

Most patients do not experience any side effects from having a musculoskeletal ultrasound. The ultrasound gel used during the exam is cool and does not usually cause any discomfort. If you have a sensitive skin condition, you may want to ask the technologist to use a hypoallergenic gel.

The ultrasound waves used during the exam are safe and have no known side effects. In very rare cases, patients may experience a feeling of warmth or tingling during the exam. If this occurs, please let the technologist know so they can adjust the machine.

How can I prepare for a musculoskeletal ultrasound?

You don’t need to do anything special to prepare for a musculoskeletal ultrasound. You can eat and drink normally before the test.

What should I expect during and after a musculoskeletal ultrasound?

You will be asked to lie on a padded table. A clear gel will be applied to the area of your body being examined. The sonographer will gently move a hand-held device called a transducer over the gel. The transducer emits sound waves that bounce off your bones and create echoes. These echoes are converted into electronic signals that are passed to a computer, which produces images of your bones on a screen.

The musculoskeletal ultrasound procedure is usually painless. However, if you have a very sensitive area, you may feel some discomfort when the transducer is pressed against your skin.

After the musculoskeletal ultrasound is complete, you can go about your normal activities. There are no special precautions you need to take.


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What is Ultrasound?

If you’re like most people, you probably think of ultrasound as a way to get a picture of your baby during pregnancy. But ultrasound can also be used for other things, like checking out your organs or looking for tumours. In fact, ultrasound is a pretty versatile tool that can be used for all kinds of different medical purposes such as guiding joint injections. So what is ultrasound, exactly?

What is ultrasound?

Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from “normal” (audible) sound in its physical properties, except that humans cannot hear it. This limit varies from person to person and is approximately 20 kilohertz (20,000 hertz) in young adults. Ultrasound devices operate with frequencies from 20 kHz up to several gigahertz.

There are many different uses for ultrasound. For example, ultrasound can be used:

– To produce images of internal organs for medical diagnosis (medical sonography)
– To monitor the flow of blood and to measure heart function (echocardiography)
– To create images of a developing foetus (obstetric ultrasonography)
– To guide needle placement during biopsies and other procedures (interventional ultrasonography)
– To clean teeth (ultrasonic dental cleaning)
– To break up kidney stones (shock wave lithotripsy)

How ultrasound works

Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from “normal” (audible) sound in its physical properties, except that humans cannot hear it. This limit varies from person to person and is approximately 20 kilohertz (20,000 hertz) in healthy young adults. Ultrasound devices operate with frequencies from 20 kHz up to several gigahertz.

How ultrasound works

When ultrasound waves hit an object, they reflect off of it. The time it takes for the waves to bounce back is used to calculate the depth of the object. The waves also change direction when they hit a boundary between two different materials – for example, the tissue interface between muscle and fat – which can be used to produce two-dimensional images.

The benefits of ultrasound

Ultrasound has a number of benefits, both for medical purposes and for other uses.

Some of the medical benefits of ultrasound include:

– Diagnosing problems in unborn babies
– Looking for problems in the heart, liver, kidneys, or other organs
– Guiding doctors during surgery
– Helping to break up kidney stones
– Reducing pain and swelling from injuries
– Treating cancer

Ultrasound can also be used for non-medical purposes, such as:

– Cleaning jewellery and glasses
– Cutting through metal and concrete
– weld outdoor power equipment

Ultrasonic waves are also used in humidifiers and nebulizers.

The risks of ultrasound

While ultrasound is generally considered safe, there are some risks associated with the procedure. One of the risks is that the sound waves could heat up body tissues. This could damage tissue or cause it to swell. These risks are more usually associated with multiple pulsing modes such as Doppler imaging, and high-frame-rate, high-line-density modes. These imaging settings are hardly used when scanning musculoskeletal tissues and if used (colour or power doppler) they are used for very short amounts of time typically less than a minute.

Another risk is that the waves could reflect off of bones or other structures in the body and cause interference in the image. This could make it difficult to get a clear picture of the area being examined.

Ultrasound may also not be recommended for pregnant women or those who are pregnant with twins or more because of the potential risks to the developing foetuses.

How to prepare for ultrasound

Preparation will depend on the type to of ultrasound you are having.

Some ultrasound examinations like musculoskeletal ultrasounds require no preparation when for some other you might have to fast for a few hours or drink water.

 

What to expect during ultrasound

You must expect different experiences depending on the kind of ultrasound you are having but in general you will lie on your back on an examination table. A clear gel will be put on your abdomen. The gel helps the sound waves from the transducer travel through your skin to your internal organs.

The transducer is a handheld device that emits sound waves and picks up the echoes as they bounce off your organs. The echoes are then translated into images on a monitor that the radiologist or sonographer can interpret.

 

After the ultrasound

You should be able to go home soon after the procedure.

 

Further reading

 

If you want to learn more about ultrasound, there are a few good sources of information:

-The Mayo Clinic has a good overview of ultrasound, including what it is, how it works, and what it can be used for.

-The American Institute of Ultrasound in Medicine (AIUM) also has a good general overview of ultrasound.

-If you’re interested in the history of ultrasound, How Stuff Works has a short article on the origins of ultrasound technology.