At Sportswise we offer on-site diagnostic ultrasound imaging using the ACUSON S3000™ ultrasound. This is Siemens’ most advanced ultrasound system with pioneering technology for producing high quality images of soft tissues.
This allows us to view your muscles, joints and tendons for a more complete assessment of your problem. Combining your history, the physical examination and the imaging by the same person produces the most precise diagnosis and leads to the best management of your problem.
This can be performed as part of your consultation with our doctors or you can book a scan without a consultation.
This state-of-the-art scanner also allows us to perform ultrasound guided injections for the most precise treatment where required.
What is diagnostic ultrasound?
The procedure involves placing a hand-held probe on the skin and slowly moving it around the area being examined. Lubricating gel is used to help the probe contact the skin and produce a high quality image.
The probe produces high-frequency sound waves which travel through the skin and are then reflected back by different body tissues such as ligament and bone. The probe receives the reflected sound waves (echoes) and the machine turns them into a picture which both the consultant and patient can see.
As the probe is moved around, the picture also moves, thus showing a “live” image.
Figure 1: A view of the whole Achilles tendon from calf muscle to attachment of the heel bone using SieScape™ panoramic imaging that provides an extended field of view.
What are the advantages of ultrasound?
The advantages of ultrasound are that it is usually painless, less expensive than MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scans and it does not involve any radiation.
It can be targeted to the area where your symptoms are, allowing you to see the images as they are produced and provides high definition pictures particularly of soft tissue, which cannot be seen well with X-ray imaging. It can also perform dynamic imaging – that is to look at the movement of your tendons, muscle or ligaments in real-time.
The Power Doppler setting is another useful tool that shows blood flow and areas of inflammation in tissue. Ultrasound can also be used to provide imaging to guide injections to different joints and soft tissues.
However, ultrasound is less good at looking at deeper body structures and the inside of joints, in which case MRI or CT scan may be more helpful.
The choice of recommended scan depends on the type of symptoms/signs you have and can be discussed at your consultant appointment.
We can arrange these other types of imaging with local providers.
Figure 2: Ultrasound of Achilles Tendon using Power Doppler. The orange area shows blood vessels that have grown into the painful tendon.
How do I know if I need an ultrasound scan?
Your Consultant at Sportswise can advise on whether diagnostic ultrasound/ultrasound guided injection therapy will be helpful depending on the symptoms that you have.
What are the risks?
An ultrasound scan involves no radiation and is therefore a very safe procedure for patients.It has been used extensively to examine babies while still in the uterus and there are no reported ill-effects.
Who will perform your scan?
Your scan will be performed by one of our doctors. They are Consultants in Sport and Exercise Medicine and have completed formal post-graduate training in the use of musculoskeletal ultrasound.
What happens during the scan?
You will be asked to lie or sit on the examination couch and remove any clothing covering the area being examined. Therefore, please wear comfortable, loose-fitting clothes for the ultrasound scan.
A clear water-based gel will be put on the skin and then the probe placed and moved over that area, in order for pictures to be taken. You may also be asked to move the joint being examined whilst the ultrasound is being performed.
The lights in the room are usually dimmed to help view the images on the screen. The scan procedure will last about 10-20 minutes. Once the scan is completed, the gel is wiped off.
Ultrasound can also be used to guide injection therapy and your consultant will discuss this with you depending on the specific procedure.
Is it painful?
The ultrasound waves themselves do not cause any pain. The pressure of the probe on the skin is usually pain free though in some people can be uncomfortable.
Please let the consultant know if you are experiencing any discomfort or are having difficulty lying/sitting in one position
What happens after the scan?
Your consultant will show you the images and discuss the findings with you immediately. A report will be written in your notes.
A further management plan will be discussed with you depending on the findings of the scan and the rest of your clinical assessment.
Figure 3: Ultrasound of the Supraspinatus Tendon in the shoulder showing the different layers. The bursa is like a flattened balloon lying over the top of the tendon and shown here as a black line above the tendon.