Skip the MRI, get an ultrasound?

TECHNOLOGY: SELINA SHAH 

When most of us think of ultrasound, we think of examining a baby in the womb. However, in recent years, ultrasound technology has progressed and the images it produces have improved.

As a result, trained sports medicine physicians can use it as a replacement for magnetic resonance imaging (MRI) to evaluate certain musculoskeletal injuries involving muscles, tendons, ligaments, nerves, bursa, and bone surfaces. Physicians can use it to distinguish between sprains, strains, partial or complete tears, and tissue degeneration.

So why might you want an Ultrasound over an MRI?

Here are just a few reasons: (1) Examination is done in the office by a trained physician. (2) It is usually signifi- cantly less expensive. (3) It allows for dynamic, rather than merely static imaging (i.e. the physician can watch a joint move). (4) It is more patient-friendly because the patient is not confined to a claustrophobic narrow tube. (5) The patient can interact with the physician to direct the imaging to the area of concern during the examination. However, Ultrasound waves cannot penetrate bone so MRIs are still recommended to evaluate structures inside a joint.

Ultrasound also offers advantages in injection procedures. It can be used to guide injections into joints, tendon sheaths, bursa, and to treat nerve conditions. Studies have shown improved accuracy with the use of ultrasound to guide injections into joints. Ultrasound can be used instead of fluoroscopy or CT scans to guide deep injections into such areas as the hip joint. This helps save the patient from radiation exposure and contrast dye. 

Selina Shah is a doctor for St. Francis Memorial’s Center for Sports Medicine in Walnut Creek.