Dr. Craig Weinstein, a sports and orthopaedic specialist at Red Mountain Medical Plaza, explains the benefits of diagnostic musculoskeletal ultrasound.
Q: Am I a candidate for a musculoskeletal ultrasound rather than a magnetic resonance image (MRI)?
A: Orthopaedic surgeons use a number of tools to help make a diagnosis. The two most common and helpful are taking a complete history and performing a thorough physical examination.
Often, we need additional tests to help see the parts of the musculoskeletal system. Most commonly, we use an X-ray because it is widely available and easy to obtain. While immensely helpful, X-rays have their limitations. Most notably, X-rays are excellent at showing the bones but not the soft tissues. This makes them ideal for revealing breaks, showing overall alignment and assessing for joint deterioration.
Soft tissues are structures like muscles, tendons, ligaments, nerves and even blood vessels that surround the bones. Traditionally, an MRI is used to help see the soft tissues. Since 2008, we have employed ultrasound to help us visualize the soft tissues. Ultrasound uses sound waves to create an image. Thus there is no radiation involved.
While an ultrasound cannot replace a traditional musculoskeletal MRI, it does offer a number of advantages. Most importantly, an ultrasound can be performed in the office without the need for a lengthy and often expensive visit to an outside imaging facility. Unlike an MRI, it can be used to measure how much flow goes through the vessels.
An ultrasound is a dynamic imaging modality, meaning if certain activities cause you pain or discomfort, they can be reproduced during your exam to look for changes. In contrast, you are asked to lie completely still during an MRI, which produces static images only. In-office ultrasounds can be used to localize the source of your pain and perform a quick screening to determine the cause of your symptoms.
For certain conditions, ultrasound offers a higher resolution and better detail than even an MRI. In addition, it can help guide in-office and other minimally invasive injections and procedures to help increase accuracy and effectiveness. New ultrasound-based therapies have revolutionized treatment for chronic conditions, such as tennis elbow, jumper’s knee, tendonitis and plantar fasciitis.
In our practice, we have reduced the use of MRI by more than 50 percent over the past five years, thanks to the increased capabilities of diagnostic musculoskeletal ultrasound. Be sure to ask your orthopaedic surgeon if you are a candidate for an ultrasound examination next time you visit with a problem.
Dr. Craig Weinstein
Sports and Orthopaedic Specialists is led by Dr. Weinstein, a magna cum laude graduate of Columbia University, who received his sports medicine fellowship training at the world-famous American Sports Medicine Institute, in Birmingham, Ala. However, he has his roots in Arizona, graduating from Saguaro High School, in Scottsdale.
Dr. Weinstein’s specialties include shoulder, elbow and knee issues, as well as athletic injuries in both adult and adolescent patients. He offers state-of-the-art joint preservation, as well as advanced treatment of injuries specific to throwing athletes, such as frozen shoulder. In addition, he offers extensive expertise in joint replacement surgery.