How To Detect Chronic Heel Pain With Musculoskeletal Ultrasound

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By John Tassone Jr., DPM

    Throughout the previous three decades, technological advances paved the way for the use of sonography in diagnosing and assessing musculoskeletal pathology. Continued innovations in this arena have led to affordable portable units that enable private office practitioners to utilize ultrasonography. Use of these units has grown over the last five years, especially in rheumatology. In fact, one leading ultrasound company has turned all of its advertising attention from the podiatry profession to rheumatology. However, podiatry still remains a formidable market for the portable ultrasound.     There are many benefits to ultrasound. Its safety profile is excellent. Ultrasound produces no ionizing radiation as evidenced by its use in obstetrics. It has no known side effects or contraindications. It is inexpensive as compared to magnetic resonance imaging (MRI). There is minimal patient preparation and it is usually painless. It can be used for purposes such as guided injections, biopsies and draining of cysts. Ultrasound also allows for real time imaging, which is indispensable for assessing tendon integrity.     However, ultrasound is also operator dependent and this becomes its leading limitation. In the educated hands, diagnostic ultrasound is a powerful tool. Being educated on this device involves more than knowing the anatomy and being able to recognize structures on the screen. Clinicians should also have a strong grasp of how the image is formed, the artifacts that can result and the variables that one controls while scanning. Accordingly, let us take a closer look at the technical aspects of ultrasound use.

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