In August 2014, JointFit Chiropractic and Sports Medicine Center continued toward its mission statement as being an elite clinic for the evaluation, diagnosis, and treatment of musculoskeletal pathologies in the central United States by equipping the clinic with diagnostic ultrasound capabilities. Diagnostic ultrasound has been used in medicine for over 25 years, but only recently has technology allowed for image optimization that is suitable to evaluate discrete anatomy of muscle, tendons, ligaments, nerves and articular cartilage.
MSK Ultrasound image of part of the rotator cuff inserting on to the humerus.
Advances in technology have resulted in diagnostic ultrasound becoming an invaluable resource in for safe, quick, dynamic, accurate, and affordable assessment of sports injuries, repetitive use injuries, and traumatic injuries to the musculoskeletal system. A musculoskeletal sonogram does NOT expose patients to harmful radiation- making it a great way to assess soft tissue and joint injuries in pediatrics and women who are pregnant. A specific anatomical structure can be evaluated in a matter of seconds, and a complete joint or region in a matter of minutes. Further more, with diagnostic ultrasound, you have the tremendous benefit of being able to stress a soft tissue or joint to see how it holds up under a load. This allows for the identification of dynamic lesions, or functional problems such as snapping or subluxing tendons, discrete avulsion fractures, joint instability, ligament sprains, and entrapment syndromes.
MSK Ultrasound image of the Median Nerve
Diagnostic ultrasound has been extremely helpful in determining the proper avenue of care for many injuries because it can confirm the exact cause of a patients symptoms. For example, knowing whether anterior ankle pain is the result of boney impingement, or inflammation of the tendon sheath can be very difficult using clinical tests. However, a sonogram will quickly demonstrate the presence of a thickened synovial tendon sheath. This allows us to take appropriate treatment measures and home care recommendations that are vastly different for each condition. The end result is a more effective treatment plan, which improves success rates.
MSK Ultrasound image showing dynamic capabilities of stress the UCL (Tommy John Ligament). This is an advantage over MRI.
There are some structures that diagnostic ultrasound are not helpful in assessing, such as the cruciate ligaments in the knee, and the labrum of the hip and shoulder. The reason for this is that these structures are surrounded by bone, which does not allow sound waves from sonography to penetrate and reflect off of deeper tissues. However, for nerves, tendons, the rotator cuff, plantar fascia, and collateral ligaments of the knee and elbow, bursae, pully structures of the fingers, musculoskeletal ultrasound is extremely helpful and correlates well with other popular imaging modalities like MRI.
JointFit Chiropractic and Sports Medicine Center is only one of a few out patient clinics in the region that have diagnostic musculoskeletal ultrasound technology and training. Dr. Foveaux of JointFit has trained under some of the giants in the field of musculoskeletal ultrasound at the first ever Upper Extremity Workshop sponsored by the AIUM held at the United States Olympic Training Center in Colorado Springs, CO in September 2014, and the Andrews Institute Diagnostic Ultrasound and Guided Injection workshop at the Andrews Research Institute in Gulf Breeze, FL in 2016 .