Ultrasound Guided Procedures
During your visit at NHI at TOA, your provider may recommend an injection for diagnostic or therapeutic purposes. At times a diagnostic injection may be used to pin-point and isolate the source of your discomfort. Many times this will be completed after our physical therapist has completed an evaluation allowing us to know what causes discomfort, what is tolerated well, and strength deficits/dysfunction. Using ultrasound for needle guidance and/or identification of the area of damage, a numbing medicine is injected into your hip joint or the localized area of damage/pain. The medication should give close to immediate relief of any pain that is originating from the joint or tissue in question. The pain felt with activity and clinical examination prior to the injection should be evaluated following the injection. Knowing whether or not there is improvement while the area or joint is numb allows us to rule that area in or out as the primary contributor to pain and dysfunction.
Many times a second medication may be injected for therapeutic benefit. This can usually be injected at the same time as the numbing medication. A commonly injected therapeutic medication is a corticosteroid. In comparison to the anesthetic (numbing medicine), the steroid can take up to two weeks to work fully and the overall affects are highly variable. Some patients get a substantial amount of long term relief of pain (several months or more) while others may see no improvement. The benefit of using this type of medication is the ability to address soft tissue pain/restrictions, weakness and inhibition, and other non-hip related pain and dysfunction while the hip joint or soft tissues are not hurting or are less irritable. In addition to steroids, NHI at TOA also has the ability to inject platelet rich plasma (PRP), viscosupplements, amniotic allograft and stem cell products.
Some patients will do very well with conservative treatments (medication, therapy, etc.) and activity modifications while others may ultimately benefit from a surgical procedure. Either way, the injection allows for both diagnostic information to be collected as well as the opportunity to prepare an individual physically for the best possible rehab experience post op.
In addition to needle guidance for injections, ultrasound also gives us the ability to aspirate joints, morel lesions, bursal fluid, cystic lesions, and any other fluid collection around the hip area. The aspirated fluid can then be sent to the lab for assessment for underlying pathologic conditions.
Below are examples of ultrasound guided procedures commonly performed at NHI at TOA.