Ultrasound-guided Procedures Provide Relief
UF Health physician serves up a new option for treating joint and tendon pain.
For people living with conditions such as arthritis, tendonitis and overuse injuries like tennis elbow, improving a patient’s symptoms and quality of life requires providers to use a multimodal approach, including procedural injections. Ultrasound-guided musculoskeletal interventions enhance precision and accuracy for the procedures used to give these patients a greater chance of symptom relief.
John Kiel, DO, MPH, CAQ-SM, an emergency medicine and sports medicine physician, is spearheading a program to increase this type of treatment at UF Health North and help ensure relief reaches the precise place.
Ultrasound-guided musculoskeletal intervention is a diagnostic and procedural tool that has been around for several decades. It uses high-frequency sound waves to create images of targeted parts of the body.
“Ultrasound provides several advantages, such as allowing you to evaluate soft tissues and bones in real time,” Kiel said. “Unlike CT, MRI and X-ray, it can be used dynamically on a moving patient. For example, you can evaluate the integrity of the rotator cuff while having the patient move their shoulder and activate those muscles.”
As the quality of this technology has improved, physicians have rapidly increased the extent of disease that can be diagnosed and treated. In Kiel’s case, it is used to guide the placement of injections, which greatly improves accuracy and decreases the pain associated with these procedures.
Minimally invasive procedures to reduce pain and stiffness affecting joints and tendons come in two general categories: corticosteroid injections, sometimes referred to as cortisone, and platelet-rich-plasma, or PRP. Cortisone is a potent anti-inflammatory. PRP uses a concentration of a patient’s own blood and platelets to accelerate healing. Both methods can be used on injured tendons, ligaments, muscles and joints with the added use of ultrasound.
The greatest benefit of corticosteroids is to treat the patient’s pain and decrease inflammation. PRP has a different goal, which is to promote healing and resolution of disease. The decision to use one over the other is based on the patient, specific disease process, duration of illness and chronic medical conditions, among other considerations.
Many patients are good candidates for ultrasound-guided procedures. Often, it allows physicians to access areas they otherwise could not, such as shoulder and hip joints and many muscles, tendons and bursae.
Most importantly for patients, this can often be done during a scheduled office visit and does not require additional appointments, evaluation or treatment by other departments. Some patients can expect significant or complete resolution of pain with one or two injections. Others may receive injections as frequently as every three months to help manage a more chronic condition, with the goal of minimizing pain as much as possible.
“The future is bright for nonsurgical orthopaedics and sports medicine,” Kiel said. “Ultrasound provides a critical supplementary service to patients with musculoskeletal complaints, in addition to other surgical and nonsurgical options.”
Visit North.UFHealthJax.org for more information on orthopaedic treatments, or call 904.383.1010 to make an appointment.