Dr. Robert Clendenin, a physiatrist at the Orthopedic Alliance Clinic in Nashville, Tennessee, spoke with us about the importance of ultrasonography in his musculoskeletal practice.
Dr. Clendenin deals with non-surgical musculoskeletal (MSK) pain, such as back or neck pain, sports injuries and occupational medicine injuries. He performs several different nerve and joint injections and electrodiagnostic studies, such as electromyography (EMG) and nerve conduction studies (NCS). These two tests are used to analyze the electric activity in nerves and muscles to help make a correct diagnosis.
Dr. Clendenin uses ultrasound for intra-articular hip injections, a commonly used therapeutic or diagnostic injection that is injected directly into the hip joint.
“Before [ultrasound], I used to have to take somebody to the OR or to a surgery center and use a fluoroscopy unit which was difficult to get approval for, was expensive and exposed the patient to radiation. Now I can just take a patient…have them stay in their exam room in the office and I can bring the machine in and do the injection and it’s very quick and easy, much less expensive and there’s no radiation exposure.”
Dr. Clendenin was motivated to look for an alternative to fluoroscopy after many insurance carriers stopped paying for sacroiliac joint injections under fluoroscopy, which left him unable to help many of his patients who had sacroiliac pain.
“The ultrasound machine gave me the ability to inject those joints in the office. As far as the cost, it does not take many injections to pay for itself.”
Dr. Clendenin discussed the benefit of using ultrasound to help guide his injections.
“I’ve started to do some of my nerve injections with it [ultrasound]. …Before I would do a carpal tunnel injection blindly, now I can actually visualize the nerve and the needle and the medicine going around the nerve. It’s much safer and better. I’m starting to branch out and do different nerve blocks with it [ultrasound] and I have done different tissue, different tendon injections and things [procedures] that are hard to do blindly.
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