Did you know there is a test that lets you see inside your body, real time, and with movement? It’s not an X-ray, MRI, CT Scan, DEXA scan, or PET scan.
It’s ultrasound! Yes, it’s the same technology physicians use to look at babies in pregnant mothers and test for blood clots. However, there is a specialty area of using ultrasound that allows a properly trained physician or physical therapist to evaluate and treat problems like arthritis in the knee, the rotator cuff in the shoulder, the ligaments of most joints, and most muscles in the body.
This diagnostic testing method is called musculoskeletal ultrasound. The ultrasound machine settings are designed to create a visual of your nerves, tendons, blood vessels, ligaments, joints, and muscles. The professional operating the unit must be an anatomy expert.
A key benefit is that you can see these body parts safely without any dangerous magnetism or radiation.
A huge advantage that musculoskeletal ultrasound has over other testing methods like MRI is that you can test the injured area with movement. We test shoulder problems frequently with motion to determine if the tendons and muscles have damage and to ensure proper function.
When ankles are sprained, you can literally see the bone and ligaments that have the damage and to what extent the damage is. You can test the ligament while actually seeing it. This is a big advantage over XRay, CTscans and MRI’s where you have to remain very still. This allows for a more precise diagnosis. And when the diagnosis is more accurate, the treatment prescription can be more effective.
For example, B. B. of Louisville, MS fell hard on concrete that left him with persistent shoulder pain for months. It affected his sleep and ability to reach to the side, behind, and overhead. With his job, these movements were important. Physical tests in the clinic showed that he had pain with rotator cuff testing. Ultrasound testing (musculoskeletal ultrasound) revealed a partial tear in one tendon of the rotator cuff along with an osteochondral defect (bone damage.) Specific therapy treatment to regenerate the tendon tear was implemented with the guidance of ultrasound and he experienced a fairly immediate pain reduction with motion improvement. Within a few weeks, the partial tear was healed and all function was normal without pain.
L.S. of Louisville had persistent knee pain when standing from a chair a good year after her knee replacement. She’d had physical therapy for her replacement, and the odd pain that remained had actually been addressed with dry needling. Ultrasound revealed extra scar with some calcium build-up under the big tendon just above the knee cap. Ultrasound was used to guide a dry needling technique that not only immediately improved her standing without pain, but it shrunk the scar and helped the body reabsorb some of the calcium.
At this time, this form of testing is hard to find. It’s even harder to find a specialist trained in using ultrasound to guide treatment. Many orthopedic surgeons and some of their nurse practitioners are able to use ultrasound to guide injections to reduce inflammation which is similar to how a trained PT uses ultrasound to actually heal a tendon.
For those strange, odd, persistent problems that there seems to be no answer for is where diagnosis and treatment with musculoskeletal ultrasound can possibly provide solutions. Be sure to talk with your physician, your nurse practitioner or your physical therapist about this valuable method of helping you get back to action faster.
Dr. M. Wade Baskin, PT, DPT
Physical Therapist
Fyzical Therapy & Balance Centers of Louisville
662–773-3700
