Ultrasound is an imaging method that uses high-frequency ultrasound to take dynamic, real-time images of the body.
Ultrasound is increasingly used to help sports medicine physicians, rheumatologists, orthopaedists in establishing the diagnosis as well as to guide intraarticular and periarticular infiltrations.
With the development of this technique, portable ultrasound scanners have also appeared which allow the investigation and infiltration to be performed at the patient’s home.
Infiltrations are useful both diagnostically and therapeutically for a variety of problems involving the hip, shoulder, knee, ankle.
The most common problems in which ultrasound-guided infiltrations are used are: gonarthrosis, rheumatoid arthritis, labral lesions, muscle and ligament tears, tendinopathies.
Ultrasound-guided infiltrations are useful when conditions do not respond to conservative treatments such as anti-inflammatory drugs, rest, ice, medical recovery.
The use of ultrasound improves the accuracy of infiltration with corticosteroids, hyaluronic acid, platelet-rich plasma (PRP), specialized progenitor cells.
Ultrasound can also be used for the joint punctures necessary for diagnosis.
Ultrasound guided infiltrations allow the physician to visualize the needle in real time as it penetrates the target tissue.
This ensures a precise injection at the desired site. Unguided infiltrations, even if the doctor is experienced, are not 100% accurate and in some joints the accuracy is 30-40%. In the case of ultrasound guided infiltrations the accuracy is over 90%. In addition, ultrasound-guided infiltrations have been shown to be less painful than unguided infiltrations.
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Advantages of using ultrasound in guiding intra and periarticular infiltrations:
– Ultrasound does not irradiate unlike radiography,
– Ultrasound can visualize both the joint and surrounding tissues thus avoiding vessel and nerve injury during the procedure,
– Ultrasound is able to better visualize fluid accumulations in joints or soft tissues compared to radiography or computed tomography.
Complications of ultrasound-guided infiltrations:
– Incomplete pain relief,
– Bleeding,
– Tissue damage,
– Infections.
In the knee, ultrasound can help visualize the quadriceps and patellar tendons, extra-articular ligaments and sometimes can diagnose meniscus injuries. It can also see if there are intra and extra-articular fluid accumulations.
At the hip joint infiltrations are used in coxarthrosis and for the diagnosis and treatment of labral lesions.
The hip is a deep joint surrounded by vessels and nerves. It is estimated that infiltrations performed without ultrasound guidance are 50-80% accurate.
Ultrasound can visualize the hip joint, bursa, muscles and tendons in the hip.
In the shoulder, ultrasound has a specificity and sensitivity similar to an MRI investigation for rotator cuff injuries. Ultrasound guidance allows a safe infiltration of the acromioclavicular joint, glenohumeral joint, biceps tendon and subacromial bursa.
Ortokinetic Team
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