When most people think of an ultrasound, they imagine a pregnant woman getting a preview look at her baby’s fingers and toes while a doctor makes sure that all is well inside the womb—however, in recent years the medical field has found many new uses for ultrasound technology. At Emory Sports Medicine, where I work as an athletic trainer with Dr. Ken Mautner, we frequently use ultrasound diagnostics to pinpoint the causes of tendon and ligament pain. From time to time, Dr. Mautner even brings out the ultrasound as an aid in treating the injury.
Until a few years ago, the go-to test for diagnosing the cause of chronic tendon and ligament pain was an MRI. We still frequently use MRI at Emory Sports Medicine – it’s the best diagnostic tool in many situations – but more and more often we’re turning to diagnostic ultrasound to get a better picture of what is going on inside our patients’ bodies.
Ultrasound offers several advantages in diagnosing tendon and ligament injuries. One of my favorite advantages – and one our patients appreciate as well – is the instant gratification we get with an ultrasound. There’s no waiting for a report on an MRI that is just a static snapshot of one moment in time. You can point to where you’re hurting, and we can immediately get a look at that precise area, in real-time motion, as you’re moving and experiencing the pain. Dr. Mautner can show you pictures from the ultrasound right there during the appointment and explain to you what he sees. It’s always interesting to watch him take a picture that might first look like a confusing blob to most of us—then he explains the picture in such a way that patients can see what he’s seeing in it and understand what’s wrong. (I stick around after he leaves to answer any further questions patients might have about the ultrasound or their injury.) I love this aspect of diagnostic ultrasound. Often, in the span of a single appointment, we can hear what’s hurting, take a look at the affected area, find the problem, show it to you, and come up with a plan of action. It’s much easier for everyone involved.
Ultrasounds also allow us to look at injuries in greater depth, picking up very small tears that an MRI might miss. “Mystery pains” with no clear cause often reveal their secrets to the ultrasound. We’re seeing this quite a bit with hip pains, which have historically been very tricky to diagnose. Diagnostic ultrasound can look deep into the hip and the many crisscrossing tissues within it to find the source of the pain. Dr. Mautner even uses the ultrasound to guide treatment of the hip pain once the cause is found. Injections are often used to treat tendon and ligament pain, but they are notoriously difficult to administer precisely deep within the hip. Dr. Mautner uses ultrasound to guide him, in real-time, as he inserts the needle, delivering the injection to the optimal spot for healing.
The more we use diagnostic ultrasound, the more advantages we’re finding. Ultrasounds do not emit any radiation, so they are safe for people with pacemakers, spinal cord stimulators, and other medical devices that cannot handle the radiation of other diagnostic tools. And there’s no risk of feeling claustrophobic.
Just to be clear, ultrasounds are not replacing other diagnostic tools. For some injuries, an MRI or other test is the best approach, and Emory Sports Medicine has some of the finest, most innovative radiologists around. But for some injuries, we’re finding that ultrasounds are very helpful to us as we diagnose and treat the source of tendon and ligament pain.
And they’re still great for looking at babies, too!
Melanie Hof, M.S., A.T.C., is an athletic trainer at Emory Sports Medicine. She enjoys ultramarathon canoe and kayak racing, biking, and running.