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Diagnostic musculoskeletal ultrasound is a painless imaging modality that uses sound waves to produce real-time images of the soft tissues and bony structures in the body, such as muscles, tendons, ligaments, nerves, and joints. It can help to diagnose and assess a variety of musculoskeletal conditions and injuries, such as arthritis, fractures, tears, strains and sprains, nerve entrapments, tendonitis, bursitis, , rotator cuff tears, joint problems, cysts, tumours and masses. It can also guide real-time interventional procedures for treatment such as steroid and hyaluronate injections or targeted shockwave treatments.

Unlike x-ray or MRI, diagnostic musculoskeletal ultrasound allows for movement during the evaluation. It is a safe and noninvasive imaging method that does not use radiation.

It has several benefits, such as:

• It is non-invasive and painless, which means it does not require any needles, injections, or surgery.
• It is safe and does not use any radiation, which means it does not pose any health risks or side effects.
• It is cost-effective and widely available, which means it is more affordable and accessible than other imaging methods, such as MRI or CT.
• It is real-time and dynamic, which means it can show the movement and function of the muscles, tendons, ligaments, nerves, and joints, as well as the blood flow and inflammation.
• It is accurate and effective, which means it can help diagnose and assess a variety of musculoskeletal conditions and injuries, such as arthritis, tear, sprain, trapped nerve, strain, tendonitis, bursitis, carpal tunnel syndrome, rotator cuff tears, joint problems, and masses. It can also guide interventional procedures for treatment, such as injections or shockwave therapy.

Musculoskeletal ultrasound can help improve the quality of care and outcomes for patients with musculoskeletal issues. It can help physicians to tailor more efficient and personalized treatment plans, as well as to monitor the progress and response to therapy.

At Oxford MSK we use industry renowned GE Health Equipment to optimise patient care.

At the Oxford Musculoskeletal Clinic we use Extracorporeal Shockwave Therapy (ESWT) with Ultrasound guidance to ensure precision, efficacy and success with our treatments. Shockwave therapy can benefit patients with musculoskeletal problems by stimulating the natural healing process of the damaged tissues. Shockwave therapy can help to:

• Reduce pain and inflammation by increasing blood flow and oxygen to the affected area.
• Break down scar tissue and calcifications that may impair the function and mobility of the muscles, tendons, ligaments, nerves, and joints.
• Enhance tissue regeneration and repair by activating the growth factors and stem cells that are involved in the healing process.
• Restore the normal function and movement of the musculoskeletal system by improving the elasticity and strength of the tissues.

Shockwave therapy can help treat various musculoskeletal conditions and injuries, such as arthritis, tear, sprain, trapped nerve, strain, tendonitis, bursitis, carpal tunnel syndrome, rotator cuff tears, joint problems, and masses. It can also help prevent the recurrence or worsening of the problems by addressing the root causes and not just the symptoms. Shockwave therapy can be used as a standalone treatment or in combination with other modalities, such as physiotherapy, exercise, medication, or surgery.

Steroid injections, also known as corticosteroid injections, are medical procedures where a corticosteroid medication is injected directly into a specific area of the body to reduce inflammation and alleviate pain. These injections can be administered into joints, around tendons, ligaments, or muscles, depending on the condition being treated. All of our injections are performed under ultrasound guidance to optimize patient outcomes and safety.

Purpose:

• Inflammation Reduction: Steroids have potent anti-inflammatory properties, making them effective in treating conditions characterized by inflammation, such as arthritis, bursitis, or tenosynovitis
• Pain Management: By reducing inflammation, steroid injections can help manage pain associated with various musculoskeletal conditions.

Conditions Treated:

• Osteoarthritis: Steroid injections can provide relief for joint pain and inflammation associated with osteoarthritis.
• Rheumatoid Arthritis: Used as part of the treatment plan to manage symptoms and improve joint function.
• Tenosynovitis: Injections can target inflamed tendons, easing pain and promoting healing.
• Bursitis: Commonly used to reduce inflammation in the fluid-filled sacs (bursae) that cushion joints.
• Nerve entrapment: Such as carpal tunnel syndrome or cubital tunnel syndrome

Procedure:

• Localized Application: The injection is typically administered directly into the affected area under the guidance of ultrasound.
• Short Duration: The procedure is relatively quick, often taking only a few minutes.

Benefits:

• Quick Relief: Steroid injections often provide rapid relief from pain and inflammation.
• Non-Invasive: Compared to surgical interventions, steroid injections are non-invasive.

Considerations:

• Temporary Relief: The effects of steroid injections are usually temporary, and repeat injections may be necessary for ongoing management.
• Potential Side Effects: While generally considered safe, there are potential side effects, such as temporary pain at the injection site, infection, or changes in skin color.

Consultation:

Always consult with a healthcare professional to determine the appropriateness of steroid injections for your specific condition. We can provide personalized advice, discuss potential risks, and explore alternative treatment options.

Hyaluronic acid (HA) injections are a medical treatment involving the injection of a gel-like substance, hyaluronic acid, directly into joints or soft tissues. This natural component of synovial fluid aims to alleviate pain, reduce inflammation, and improve joint function.

Purpose:

• Joint Lubrication: Hyaluronic acid is a key component of synovial fluid, which lubricates joints and reduces friction between bones.
• Shock Absorption: Enhances the joint's shock-absorbing properties, improving overall joint function.
• Anti-Inflammatory Effects: Provides relief for conditions such as osteoarthritis through its anti-inflammatory effects.

Conditions treated:

• Osteoarthritis: Commonly used for knee osteoarthritis, hyaluronic acid injections aim to improve joint mobility and reduce pain.
• Joint Pain: Can be considered for other joints affected by osteoarthritis or inflammatory conditions.

Procedure:

• Administered in the same way as steroid injections.
• Injection Site: Commonly injected directly into the affected joint, guided by ultrasound.

Benefits:

• Improved Joint Function: Enhances joint lubrication, potentially improving mobility.
• Pain Relief: Provides relief from pain associated with osteoarthritis or joint degeneration.
• Minimally Invasive: Non-surgical option for managing joint discomfort.

Considerations:

• Temporary Relief: The effects of hyaluronic acid injections are often temporary, and repeated injections may be required for ongoing management.
• Potential Side Effects: Generally considered safe, but there may be mild, temporary discomfort at the injection site.

Consultation:

Individuals considering hyaluronic acid injections should consult with us to determine the appropriateness of the treatment for their specific condition. We can assess your medical history, discuss potential benefits and risks, and explore alternative treatments. We offer multiple options of injection which we can explore further with you.

Prolotherapy is a treatment that involves injecting a solution containing an irritant, usually dextrose, into a damaged or injured area to stimulate the body's healing response. Some of the benefits of prolotherapy for musculoskeletal conditions are:

• It can treat injured muscles, joints, tendons and ligaments in various parts of the body, such as the knees, hips and shoulders.
• It can reduce pain and stiffness, improve strength, function and mobility of the joint, and increase the strength of ligaments and other tissues.
• It has very few side effects and is a relatively low-risk treatment.
• It can be used with other treatments and techniques to manage pain, but make sure to talk to your provider before starting it.

Prolotherapy is not a standard treatment for any disease, condition or symptom. Experts have found that it can benefit some people in certain situations, but it's still not universally accepted because research has found inconclusive results.