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a. MRI of abnormal achilles tendon showing fluid in tendon.
b. Ultrasound of abnormal achilles tendon showing wiidening (arrows)
and (below image) fluid within the pre-Achilles bursa (arrow). Fluid can
then be drained under ultrasound guidance.
a. Thickening of the common extensor tendon (T) with abnormal doppler
signal at its proximal insertion into the lateral epicondyle.
b. Contralateral normal elbow. H = humerus; R = radius.
c. Needle injection seen under ultrasound guidance.
Lateral 'Epicondylitis' ('Tennis Elbow')
Shoulder Calcific 'Tendonitis'
a. X-ray of calcium deposit
b. Ultrasound of needle insertion into calcium deposit. Calcium can then be lavaged,
broken up, and aspirated through the needle and syringe, without surgery.
a. MRI of abnormal patella tendon with signal at insertion on patella.
b. Ultrasound of normal (left) and abnormal (right) patella tendon.
Prolotherapy or platelet rich plasma can then be injected under direct
Dr. Silberman offers ultrasound examination and guided
injections of cortisone, prolotherapy, and platelet rich plasma.
Ultrasound imaging uses high-frequency sound waves to produce pictures of the inside
of the body. Ultrasound imaging uses no ionizing radiation (like x-rays), gives a clear
picture of soft tissues that do not show up well on x-ray, has advantages over MRI in
seeing tendon structure, and causes no known health problems. Because ultrasound
images are captured in real-time, they can show the structure and movement. Most
ultrasound examinations are painless, fast and easy. Gel is placed on your skin and
then a transducer is placed firmly against your body, moving it back and forth over the
area of interest until the desired images are captured.
Ultrasound imaging to deliver injections is superior to blind injections and can improve
the diagnosis, accuracy and ultimate effectiveness of Injection Therapy.