TRAINING AND EDUCATIONAL EXPERTISE

With the proper training, musculoskeletal ultrasound will add dynamics to your practice that you and your patient will appreciate. Esaote is committed to insuring that you are at the highest level of expertise when diagnosing your patients with our high resolution scanners. As the fourth largest manufacturer of ultrasound equipment worldwide, we have developed a program which will satisfy your educational needs.

DIAGNOSTIC ULTRASOUND AND HOW IT WORKS

A diagnostic ultrasound system provides an image of patient’s internal organs or soft tissue by transmitting short bursts of ultrasonic energy into the body, producing
echoes as the energy bursts encounter acoustic interfaces caused by differences in tissue impedance (intensity) characteristics. The scanner measures the intensity of these echoes, the time between them, and their direction. This information is processed and used to generate the ultrasound display.

Principal of operation Ultrasound energy, or ultrasound, refers to the high-frequency sound above the level of
human hearing (greater than 20.000 Hz [cycle/sec]). For diagnostic imaging, frequencies ranging from 2 to 20 Mhz are typically used. Ultrasound waves emit mechanical vibrations which require a tissue medium for
transmission. They can be predictable aimed, focused and reflected as they exhibit normal wave properties of reflection, refraction and diffraction.

A transducer, which consists of piezoelectric elements, is placed on the skin after Acoustic coupling gel is applied to the skin surface as a contact. The transducer converts an electric signal into ultrasonic energy, which can be transmitted into tissues. Some of the ultrasonic energy transmitted through the body tissue by the transducer is reflected back toward the source when it reaches a boundary between tissues of different densities, producing an echo. The transducer reconverts this echo into an electric signal. Large differences in tissue impedance (intensity) characteristics result in a high degree of reflection. The nature of tissues and their boundaries are determined from these echoes and the time elapsed between them.

Several different types of transducers can be used; the frequency of the beams of these transducers emit depends on the thickness of the piezoelectric crystal. Transducers that generate higher frequencies produce shorter wave lengths and narrower beams thus improving image resolution. Higher frequency sound energy is more readily absorbed by tissue and the available depth of penetration is decreased. Higher frequencies can be used to obtain improved image resolution where deep structure evaluation is not necessary.

The ultrasound system contains an operator adjustable compensation system to increase amplification from more distant interfaces. The scanner measures the intensity of echoes, the time between them and their direction. This information is then processed and used to generate the ultrasound display. Various modes are available for displaying the returning like B-Mode and M-Mode.

PODIATRIC INDICATIONS

Pathologies in which ultrasound has proven beneficial to the podiatrist in the office include but are not limited to:

• Plantar fascia tears, inflammation
• Plantar Fibroma
• Achilles tendonitis, tears, rupture
• Cystic Mass (ganglions)
• Retrocalcaneal Bursitis
• Morton’s Neuroma
• Tibialis posterior, rupture, dysfunction
• Tarsal Tunnel Syndrome
• Bursitis
• Ligament strain, tears
• Ankle sprain, strain-joint effusion
• Foreign bodies
• Stress Fracture
• Muscle injury, rupture
• Extensor and Flexor tendonitis, tears, ruptures
• Ultrasound guided injection and/or aspiration
• Wounds

Summary
Musculoskeletal Diagnostic Ultrasound (MSK) is a valuable adjunct to the podiatrist physical exam. MSK provides a quick and painless aid to diagnosis and treatment of soft tissue and bony injury and/or pathology. The patient is afforded an immediate treatment without being referred for an expensive and often uncomfortable diagnostic study. MSK is quickly becoming the standard of care as the most cost effective diagnostic study the podiatrist can perform in their office.

Codes

Code 76880:
Echography, extremity, non-vascular B-Scan and/or real time with Image documentation.

Code 76942:
Ultrasound guided needle injection/aspiration.

TESTIMONIALS from ACTUAL TRAINING CLASSES

"It was better than Cats,
I'll take it again and again."
-L. Whittenberg, DPM

"Excellent presentation
and hands on lab."
-V. Cibella, DPM

"I was concerned with what I may have missed due to inadequate imaging. The techniques used in this course enhanced my ability to diagnose and treat pathology with accuracy."
-T. Hale, DPM

• Training and Educational Expertise
• Diagnostic Ultrasound and
  How it Works
• Podiatric
  Indications
• Training Class
  Testimonials