The medical diagnosis establishes the injury or illness that is suffered by a person, based on the symptoms, signs and discoveries from complementary explorations as imaging tests. It is a complement to the assessment made by the physiotherapist in our clinic, in which the patient is given a concrete diagnosis of his or her injury by a traumatologist specialized on ultrasound and orthopaedic surgery. Moreover, an explanation of the treatment needed is given, including both a treatment that the traumatologist can carry out at the moment, or an explanation and planification of a possible surgery in the case that this is required.
Due to its easy and immediate access, musculoskeletal ultrasound has turned into the referential diagnostic, prevention and treatment guided technique. It is one of the imaging techniques on which the traumatologist bases his concrete medical diagnosis. Together with other imaging techniques that can be provided by the patient, such as radiographies or magnetic resonances, the ultrasound-specialized traumatologist scans the patient with this technique to make an instantaneous and precise diagnosis. Apart from it being a diagnostic method, the doctor is based on the ultrasound to conduct ultrasound-guided treatments such as infiltrations, fluid aspirations or calcification lavages accurately, specifically and safely.
The infiltration concept defines the injection of a medicament in a joint or soft tissue so that it acts in the affected spot in painful and inflammatory processes. It is indispensable to use the ultrasound to guide the infiltration because it allows us to visualize the needle in real time and to control the infiltration spot. The infiltrated products are divided y various groups depending on the type of medication:
- Steroid medication. Its aim is an anti-inflammatory one.
- Anaesthetic medication. Its aim is the immediate decrease of pain.
- Hyaluronic acid. It restores the protective viscoelasticity of the synovial fluid of the joints. Acts as a lubricator reducing the friction and enhancing the articular mobility.
- Arthrosis of different joints (hip, knee)
- Inflammatory processes of different joints
- Subacromial Bursitis
The procedure of a fluid aspiration is carried out when the body presents an exaggerated fluid spillage or effusion that can either create pain for the patient or an occupation of essential space for the structures of the body. This fluid is aspirated by a needle that enters the exact point of fluid effusion. It is indispensable to use the ultrasound to guide the aspiration because it allows us to visualize the needle in real time, consequently controlling its trace and localizing the aspiration spot accurately. The most common fluid effusion and respective aspirations are done in the following injuries:
- Articular effusion of synovial fluid (typical in knees).
- Blood and fat cell effusion in calf strains.
- Encapsulated hematic effusion on muscular strains.
- Post traumatic Morel-Lavallée effusion.
- Synovial cysts and ganglions.
The ultrasound guided purging technique for shoulder calcification consists in placing a needle, previously helped by local anesthesia, in the core of the calcification in order to purge its calcific content. This procedure is developed by injecting pressurized saline serum to break the calcification wall and purging its content to a syringe. The most frequent calcifications happen in the supraspinatus tendon. It is indispensable to use the ultrasound to guide the treatment because it allows us to visualize the needle in real time, consequently controlling its trace and localizing with accuracy the calcification and the procedure spot.