ECU 2010 Jane Cook DC, DACBR, MSc(APD)

Jane Cook DC, DACBR, MSc(APD) – A senior lecturer at the AECC, Jane lectures on Investigative Imaging to both undergraduate and postgraduate students. She is currently undergoing further training in the area of musculoskeletal ultrasound (MSK US) and is involved in the development of the certification programme for MSK US at the AECC.

Thursday, 13 May

Workshop,
Session 3A/4A
14.30-18.00

Diagnostic Musculoskeletal Ultrasound; Applications in Chiropractic Practice

Ultrasonography (US) is an imaging modality that uses sound waves to create an image. It involves the sending of sound waves in the higher frequency range of >20,000 Hz through the body. These sound waves are reflected off the internal structures at tissue interfaces. Special instruments interpret the reflections and create an image of anatomic parts. No ionizing radiation (x-ray) is involved in ultrasound imaging.

Diagnostic Musculoskeletal Ultrasonography (MSK US) is a useful way to detect problems in muscle, tendon and ligament pain. Ultrasound images are captured in real time, so they can often show movement, function and anatomy. This enables the practitioner to diagnose a variety of musculoskeletal conditions and assess for damage to soft tissues after an injury or illness (1).
Ultrasound images can be useful in diagnosing tendon and ligament swelling, sprains or tears. Examples include rotator cuff injuries in the shoulder, Achilles tendon tears in the ankle and ligamentous sprains in the knee (2).
MSK US is an excellent technique for evaluating soft tissue and cortical involvement in many conditions affecting the extremities. Its use has been recognised by rheumatologists over the past decade and MSK US is now employed to detect and monitor early bone erosions/joint effusions in rheumatoid arthritis and other inflammatory arthropathies (3).

The main advantages of MSK US are dynamic real-time scanning, absence of radiation, low cost, exact localization of symptoms and, most importantly, patient acceptance. To aid in diagnosis, the clinician performing the scan can correlate the clinical findings with the ultrasound images and immediately compare the contra-lateral side.

This workshop will give an overview of the developing importance of MSK US in the field of musculoskeletal practice. A variety of cases will be presented to demonstrate the scope and limitations of this form of imaging in a chiropractic practice. This workshop will focus on ultrasound imaging of the lower limb with particular reference to the knee, ankle and foot. There will be an opportunity for delegates to gain some ‘hands on’ experience of scanning and the upper limb can be discussed at that time.

References
(1). Lew HL, Chen CPC, Wang T-G, Chew KTL: Introduction to musculoskeletal diagnostic ultrasound: examination of the upper limb. Am J Phys Med Rehabil 2007; 86:310-321.

(2). Grassi W, Filippucci E, Farina A, Cervini C: Songraphic imaging of tendons. Arthritis Rheum 2000; 43:969-76.

(3). Balint P, Sturrock R, Musculoskeletal ultrasound imaging: a new diagnostic tool for the rheumatologist? British Journal of Rheumatology 1997;36:1141-1142.