ULTRASOUND
High-resolution ultrasound: a ‘live view’ beneath the skin
Pain in the musculoskeletal system is often difficult to pinpoint. Is it the tendon, the muscle, or perhaps the joint? In modern pain medicine, we replace guesswork with knowledge. Using high-resolution ultrasound (sonography), we can immediately visualise the cause of your symptoms – gently, without radiation, and in real time.
“Today, we use ultrasound as the stethoscope of the sports and pain medicine specialist. We can see the joint in motion and guide needles with millimetre precision. This significantly increases safety and the success of treatment.”
– Dr. med. Aschl
1. Diagnostics: Real-time precision
During your consultation, we use an ultrasound scan to examine your joints, muscles and tendons. The key advantage is that we perform a dynamic examination. Whereas an MRI scan only provides a static image, ultrasound allows us to see what happens when you raise your arm or bend your knee. Is the tendon snapping? Is the bursa inflamed? We can see the pain in action. This ensures clear and targeted diagnosis – without the radiation exposure of X-rays – and consequently also appropriate treatment.
Scope: Ultrasound medicine in various specialist fields
Ultrasound is a versatile tool. Whilst cardiologists use ultrasound on the heart (echocardiography) to examine heart valves, and general practitioners scan the abdomen, we specialise in medical ultrasound of the musculoskeletal system (musculoskeletal ultrasound).
2. Treatment: The era of ‘needle guidance’
Diagnosis is the first step; treatment is the second.
Ultrasound allows injections to be precisely guided, ensuring that medication reaches the exact site of the pain.
We can see the tip of the needle in real time on the monitor. This means that we do not inject into the tendon (which would be harmful), but precisely at the tendon or into the joint space. This maximises the effect and minimises the pain.
Ultrasound treatment offers a range of therapeutic options:
- Ultrasound can be used to support neural therapy (local anaesthetic). In this procedure, pain-triggering trigger points, nerve structures or interference fields are precisely treated with ultrasound to calm the autonomic nervous system.
- Hyaluronic acid and autologous blood treatments offer a natural solution. Regenerative procedures such as PRP (platelet-rich plasma) are highly effective. They must be delivered precisely to the site of the injury (e.g. a torn tendon). Ultrasound therapy ensures that not a single drop of the active substance is ‘wasted’ in the surrounding tissue.
Acute pain management
When a joint is acutely inflamed (‘active osteoarthritis’) and swollen, every hour counts. For more severe pain, cortisone can help to quickly reduce the inflammation. Here, too, the dose makes the poison. By administering the injection precisely under visual guidance, we can often use smaller amounts, as the active ingredient reaches the site of inflammation in a concentrated form.
Once the pain has subsided and you have regained your normal range of motion, it becomes easier to implement the physiotherapy measures aimed at stabilisation. We also see the injection as a ‘door-opener’: it relieves the acute pain so that you can start exercising again. After all, healing comes through movement.
3. Typical applications in medical ultrasound
In our practice, we use ultrasound on a daily basis for:
- Shoulder: calcific tendinitis, rotator cuff tear, bursitis, AC joint osteoarthritis.
- Knee: Baker’s cyst, ligament sprain.
- Elbow: tennis elbow or golfer’s elbow.
- Hand & foot: ganglion cyst, Achilles tendinitis, carpal tunnel syndrome.
- Muscles: Muscle strains, haematomas.
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