Here's a sobering statistic: As many as HALF of injections done "blind" (without image guidance) miss the target! In an article published in 2013 by the American Journal of Sports Medicine, it showed that the accuracy of injections was given based on palpation (feeling for landmarks) versus using ultrasound. They compared injections given to Cadavers to those given to live patients ("Clinical"). Looking at the Knee joint, the accuracy of injections based on Palpation (Clinical) is as low as 40%. That means that in some studies the doctors missed the joint 60% of the time! But when done under Ultrasound Guidance the accuracy was 75-100%. In the hip, the BEST result for clinical palpation guided injections was 78%, while for US Guided it was 100%!
Even with ultrasound, it's no guarantee that the physician, PA, or Nurse Practitioner knows what he/she is doing. Dr. Tortland recalls a patient that he saw with ankle arthritis. The patient had said that, prior to consulting with him, he been given two cortisone injections into the ankle joint under US guidance by another provider that didn't help, and he was told that his ankle pain was NOT coming from his arthritis. Dr. Tortland suspected that the injections weren't done properly and suggested that the patient try one more time with Dr. Tortland administering. This time the patient had 100% pain relief!
When you have an injection given, particularly if it's to help diagnose or pinpoint the cause of your pain, and especially if you're paying out-of-pocket for injections that aren't covered by insurance, you want as much as assurance as possible that the injection was actually given correctly! Also, as physicians, we don't want to be wondering if your lack of response to an injection was because the injection missed the target.
At Valley Sports Physicians, we're nationally recognized experts in musculoskeletal ultrasound. In addition to assuring the accuracy of injections, musculoskeletal ultrasound helps ensure the safety of injections. That's because we can see not only the target, we're trying to inject but also the surrounding nerves, blood vessels, and organs that we DON'T want to inject! And we can guide the needle in live real time with surgical precision to the target while avoiding damage to surrounding structures. You can’t do this with x-ray guidance (fluoroscopy). Fluoroscopy also is incapable of seeing nerves and blood vessels that might be in the way. With us, you can be assured that you're in the very best and skilled hands regarding ultrasound guided injections.