Dynamic ultrasound imaging
The ultrasound examination is dynamic because it is performed in real time, showing motion live with patient’s interaction. The musculoskeletal physician can put the patient in motion to reproduce the pain or symptoms and focus on that region under real-time ultrasound to find out its causative structure or mechanism. The result is a more directed examination, specific for each individual.
Dynamic ultrasound imaging is a rapidly developing, powerful diagnostic tool in musculoskeletal medicine. Compared to other cross-sectional imaging modalities, ultrasound has several inherent advantages: ready accessibility, portability, quick scan time, and better patient tolerability. Newer innovative features such as tissue harmonics and 3-D imaging may be helpful in the diagnosis of musculoskeletal disorders in future.
Ultrasound guided injections
In the days before musculoskeletal ultrasound is available, sites for joint injections can only be located by palpations which are often inaccurate. Eustace, (1997)1 and Yamakado (2002)2 have demonstrated poor accuracy of steroid placement from palpation guided injection techniques.
High-resolution ultrasound has proven accurate and reliable in diagnosing a wide range of musculoskeletal disorders compared with clinical examination, MRI and arthrogram. (Dinnes, Loveman, McIntyre and Waught 2003)3.
With the help of these high-resolution ultrasound machines, injections can be placed under direct ultrasound monitoring exactly to the spot where the injection is plan to be placed. It's accuracy, safety, and simplicity has been widely described. (Koski 20004, Balint 20025, Naredo 20046). Advantages include short procedural time, no limitation on imaging plane, relatively low cost, lack of ionizing radiation and more readily available.
在肌骼超聲波發明之前，醫生只能靠觸感找出體位作注射治療，但很多時注射的位置是不準確的。Eustace (1997)1 和Yamakado (2003)2 的研究就顯示了觸感引導下注射類固醇的位置的不準確度。
與臨床檢查、磁力共振掃描、關節內窺鏡檢查相比較，高清晰度超聲波掃描已被證明可以更準確及可靠地診斷各式各樣的肌骼科疾病 (Dinnes, Loveman, Mclntyre and Waught 2003)3。
有了這些高清晰度超聲波儀器的幫助，注射治療可以在超聲波掃描的導航下做到更準確，甚至能夠直達患處。它的準確性、安全性和簡單性已被廣泛肯定 (Koski 20004, Blaint 20025, Naredo 20046)。
HKIMM Annual Scientific Meeting 2017
An Update on Musculoskeletal Medicine Skills
7 – 9 July 2017
Diagnostic Musculoskeletal Ultrasound & Injection Technique Workshop
18 – 20 August 2017
The Salisbury – YMCA of Hong Kong