Clinical and Research Uses of Ultrasound Imaging

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Clinical and Research Uses of Ultrasound Imaging

• Noelle Selkow, MEd, ATC
• 2nd Year Doctoral Student
• University of Virginia

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Overview

• History of USI
• Terminology
• Overview of Images
• Early Studies
• Clinical Application
• Research

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Ultrasound Imaging (USI)

• Used since the 1950s for diagnostic purposes
• Advances in technology have made it safe,
  portable, objective, and inexpensive
• Musculoskeletal imaging rapidly after 1980s

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USI

• First musculoskeletal image for rehab purposes
  was in 1968
• Dr Archie Young and colleagues at Oxford in the
  80s began USI with PTs

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USI Terminology

• Sound 3.5-15 MHz
• Penetration depth sound wave travels
• Intensity, frequency, and speed
• Attenuation energy decreases as it penetrates,
  until completely dispersed
• Reflection, refraction, scattering, absorption
• Attenuation and frequency have direct relationship

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Terminology

• Artifact incorrect representations
• Assumptions violated
• Enhancement, shadowing, reverberation
• B-Mode (Brightness Mode)
• Cross-sectional grey-scale image
• Large viewing area
• Muscle parameters, positional relationships
• Biofeedback

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Terminology

• M-Mode (Time-Motion Mode)
• Continuous image over time
• Middle of transducer
• Changes in muscle thickness overtime

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What am I looking at?
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Clinical Application of USI

• Biofeedback
• Tendon injury
• MTJ
• Atrophy/Hypertrophy
• Detect changes overtime
• Guided implantation of IM-EMG, thermocouples, and
  epidurals

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Research Using USI

• Exercises that support local stabilization of TrA
  and multifidus
• Abdominal hollowing
• Quadruped
• Fat thickness compared to pinch calipers, affect
  CAR
• Muscular discrepancies between injured/non-injured
  populations

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Research

• Correct muscles being targeted during exercise
• Short foot exercises
• Arterial diameter
• Changes during modality applications

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Researches using USI

• Deydre Teyhen, Pt, PhD
• Assistant Professor, US Army-Baylor University
  Doctoral Program in PT
• TrA activation during exercises for LBP
• Julie Hides, PhD
• Senior Lecturer, The University of Queensland,
  Brisbane, Austrailia
• Changes in multifidus CSA after stabilization
  training

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Contrast Enhanced Ultrasound

• Contrast agent used (microbubbles)
• Smaller than RBC
• Blood flow measured
• Determine velocity during injury and modality use
• Measure vascular changes in diameter

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Conclusions

• Evolving technology
• Many clinical uses
• Numerous research opportunities
• Time and patience
• The sky is the limit!!