The Ultrasound is a powerful diagnostic tool that has been around since the 1970’s. This effective tool is used for imaging evaluation of musculosketal disorders and provides highly detailed and fast information regarding a variety of clinically relevant structures of the musculoskeletal system These include tendons, muscles, nerves, ligaments, joints and bone.
Recently there has been an increased demand for expanding the clinical applications of musculoskeletal sonograph. This imaging is becoming more widely utilised in the routine evaluation of the musculosketal system mainly due to contributing factors such as continual improvements in technology, wide availability, and comparatively lower costs than CT–scan and MRI’s.
There have been great advances in technology with higher frequency transducers and contrast dyes of Doppler capability, all of which has facilitated the progressive development of sonography. Sonography development now allows us to detect abnormalities in the upper limbs and other small anatomical areas as well as joints of the hand and fingers.
Like all ultrasound imaging, musculosketal sonography is highly operator-dependent and experience and appropriate training is central to executing consistent, high quality studies.
Presently, a musculoskeletal ultrasound of the hand, wrist and elbow is offered on a routine basis at only a limited number of facilities in Italy and Switzerland. Most radiological training programs do not perform a significant number of musculoskeletal ultrasound examinations; therefore they do not include this modality as part of their curriculum.
Diagnostic use of ultrasound findings is greatly enhanced by knowledge of the clinical presentation. Among physicians, surgeons have historically the best knowledge of anatomy and pathology.
Ultrasonography (US) has long been the domain of radiologists. However, with advances in technology and wider availability there is a larger trend among surgeons in various specialties to integrate US into their routine clinical assessment. More recently hand surgeons have started using US for quantitative and qualitative real-time assessment of musculoskeletal pathology, in Switzerland, a sub-specialisation. US are increasingly being used as an extension to physical examination. Equally, the skillfulness of US with its prerequisite anatomical knowledge makes the clinical diagnosis more precise and reduces uncertainty in the choice of therapy.
There are endless advantages of using Ultrasonography. US demonstrates the most practical and speedy method of obtaining images of the musculosketal system. US is easily and promptly carried out in the clinic. Assessment of multiple joints and all queries are answered in just one visit. No more waiting for follow-up appointments. This rather inexpensive technology offers our clients several inherent advantages especially the provision of portability and real-time dynamic examinations. US is well received by patients as it is non-evasive, quick and radiation free.
From a clinicians’ point of view the US allows contralateral examination and does not pose limitations arising from metal artifacts, which can pose problems in magnetic resonance imaging (MRI).
This powerful tool has the ability to visualise needles and target structures in real-time, making it the ideal tool for the guidance procedures used in diagnosis and management.
Ultrasonography that is carried out by the physician allows for an excellent opportunity for patient education and the opportunity to explain the rationale for treatments. With growing experience the examiner has the skill to perform a focused examination with immediate answers to any clinical problem.
In addition to the above advantages US is extremely helpful in detecting the most common causes of hand pain and discomfort for everyday people and those that are involved in sport.
Carpel Tunnel Syndrome, trigger finger, tenosynovitis, small fractures, tennis elbow, joints and tendons inflammations, osteoarthritis, ligaments and tendon ruptures are among the most common conditions diagnosed by a High-frequency US examination.
Following a three-year training program in 2014, Dr.Lucchina took the post-graduate title of Swiss specialist in ultrasonography of the musculosketal system. Dr. Lucchins has provided clients with the concept of an ‘all-in-one’ appointment. Specialist Dr. Lucchina provides clients with a fast and correct diagnosis along with a ‘state-of-art’ postoperative care giving our clients a better functional outcome.