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 specializes in ultrasound examination of tendon,
ligament, and muscle injuries and ultrasound guided injections of
cortisone, prolotherapy, tenotomy, platelet rich plasma (PRP), and
bone marrow aspirate (which contain stem cells). Dr. Silberman holds
a certification in the specialty of musculoskeletal sonography from the
American Registry of Diagnostic Medical Sonography (ARDMS), the
globally recognized standard of excellence in sonography. Dr.
Silberman can save you time and money by diagnosing tears right in the
office without the need for an expensive orthopedice MRI.
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 orthopedic injuries, 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 with less pain and complications.
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