Ultrasound examination with contrast

Ultrasound examination with contrast
Ultrasound examination of injuries in the musculoskeletal apparatus can sometimes be challenging. Some patients are less "ultrasonic friendly" due to skin type, tissue or fat mass. This can cause degradation and thus an inaccurate diagnosis.

On Apexklinikken we have the technology and expertise to perform a so-called contrast examination. This does not differ significantly from the contra investigations carried out in connection with, among other MR arthrography (magnetic imaging with the contrast injection into the joints), but are associated with less risk of side effects.

Use of liquid contrast
Fluid produced an echo poor area on an ultrasound image. The sound waves are passed into the tissue through the ultrasound probe is moving very quickly through the liquid, as compared with the speed in other tissues. This produces a phenomenon called enhancement of ultrasound language. All that is deeper than the area of ​​fluid produced in the ultrasound screen with clearer details and more powerful signal.

In addition, an ultrasound image only an echo of the audio signals sent into the tissue. This leaves room for errors. Upon rupture of a tendon then done by a static image is not always able to produce damage to the tissue seems to be as it should. By setting tissue tension, one can then in some cases, see the damage open up and be prepared in our screen. The problem pops up when including a rupture is not vertical but horizontal. This will not be such a stretch of the tissues giving more information. Fluid is injected around the suspected damage will circulate into the cracks / damage when the injection pressure increases and thus produce injury in a superb way.

Where appropriate contrast ultrasound itself?
The use of contrast is particularly relevant in damage rotatormansjetten shoulder. The four muscles that encircleth humeral head to the upper arm bone has a number of important roles in shoulder function, and damage to one or more of these can cause pain and reduced function. By setting a contrast of the mucus bag enclosing these 4 tendon attachment then one will in an efficient manner to produce the extent of any damage. Rupture (tear-off) that would otherwise be overlooked seen more clearly when the liquid fills the injury site.

Contrast injection into joints may also be useful for assessing including meniscus and joints lips (cartilage discs), where small subtle damage can also represent substantially pain and functional impairment for the person concerned. The use of this diagnostic method puts great demands on the investigator when it comes to clinical and sonographic skills. Such damage can sometimes be difficult to find on a conventional MR examination, and the gold standard MR arthrography (MRI with contrast). An MR arthrography costs today over 3000 kr performed at a private radiology department.

Damage to tendons, tendon attachments, ligaments and musculature can also be difficult to determine when to define the extent of the damage. A contrast examination with ultrasound can provide more information about the extent of the damage and thus the need for surgery or other treatment.

The method
The technical implementation of the contrast study is not very complicated. One must first perform a physical examination where there are a working diagnosis. This gives the investigator a number of possible scenariorer one would want to look into. A standard static and dynamic ultrasound examination performed to obtain more information about the injury scenario.

Under sonographic guidance so be it as a mixture of numbing agent (local anesthetic) and sterile saline to the assumed damage area. The investigator can constantly monitor how the contrast medium is distributed in tissues and detect whether there is a more severe injury than the conventional images can prove. After the injection, then one can move the ultrasound probe around the area and "shoot" the injury while performing various clinical tests and movement of the injured body part.

After the examination
The patient may or may not experience any pain or discomfort after such an examination. This is because local anesthesia that attaches only lasts a few hours. When the effect of this ebbing out so it can be experienced as explosive in the area. It is therefore recommended that you take a painkiller for the first day to avoid unnecessary sensitization of the tissue surrounding the injury. Information about the use of medications for a contrast examination will be provided after the consultation.

The cost is considerably lower
A normal contrast examination takes about 30 minutes. The price is $827 for examination of one area. The need for more studies of other body parts as extra costs associated with time spent and injection.

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