The role of ultrasound in a physical medicine and rehabilitation practice

Adam Mullan, M.D.
Physical Medicine and Rehabilitation
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I would say over the past 20 years ultrasound has emerged to be a very important clinical tool not only to aid us in the diagnosis and evaluation of certain musculoskeletal complaints, but also to assist us when it comes to injections. Landmark-based injections work well, and there are studies that show they generally end up with the medication in the correct position, but there's nothing like doing an injection under ultrasound guidance and seeing the needle tip exactly where you want the medicine to go.

Ultrasound instills confidence in both the injector and the patient alike knowing that if the injection doesn’t work, it's not because the injection wasn’t placed in the right location. There's a level of safety there as well. The patient knows that we are able to see the nerves and blood vessels around the area of the injection and that we are able to avoid those because we can see our needle in the trajectory.

I think ultrasound is going to become standard of care with joint injections and soft tissue injections in the future. Evidence shows that injections are more accurate with ultrasound guidance. The availability of ultrasound is becoming more available in clinic spaces and with ultrasound-guided injections being so affordable for patients, it just make sense for physical medicine and rehabilitation providers to use it.


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