Yale New Haven Hospital is among the growing community of progressive physicians integrating ultrasound into their orthopaedic practice.
I believe musculoskleletal ultrasound will become a standard tool to help physicians in orthopaedics & sports medicine, much like it is in Europe. With advancements in technology, ultrasound provides unbelievable images of tendons, ligaments, and fluid inside the body. These images are very useful for diagnostic purposesand also guide the physician with injection procedures to ensure accuracy within millimeters of the target. Anecdotally I have found that patients getting cortisone injections have less discomfort with ultrasound guidance because painful structures like bone & tendon are avoided. Also patients enjoy the interaction that ultrasound provides with the physician. Patients can for example move their shoulder around to a particular position to reproduce pain that may not be seen with a static exam like x-ray or MRI. Also ultrasound is cost effective.
A series of studies examined the use, training, outcomes and accuracy of surgeon-held musculoskeletal ultrasound at Yale School of Medicine and Duke Medical School. Researchers found that orthopaedic surgeons can reduce overall time to patient diagnosis, enhance subjective and objective clinical outcomes, and significantly lower some out-of-pocket expense for patients. Results of the studies were presented at the 2008 American Academy of Orthopaedic Surgeons (AAOS) and American Institute of Ultrasound Medicine (AIUM) annual meetings.
http://www.ynhh.org/press/2009/orthoultrasound.html
Data was released from Krakow Poland at the International Meeting on the use of Autologous Growth Factors in Orthopaedics and Sports Medicine: “State of the Art” – Krakow, Poland – 24 April 2009. The study found that patients receiving cortisone showed a 40% improvement compared to PRP 75% at 12 months. This is the first head to head study. Cortisone is well known to carry a risk of weakening & rupturing a tendon & is often discouraged.
