color doppler necessary for joint shots?
Started by latinman
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
color doppler is for large vessel flow and is insensitive for picking up hyperemia of tendons/muscles. Power doppler is more sensitive for that. Anyways, it all depends on what you want. If you're trying to differentiate a cyst from a vessel then yes it's important. If you're evaluating neovascularization, hyperemia, synovitis then it's also important. If you end up using ultrasound a lot I would expect you to use dopplers.
Advertisement - Members don't see this ad
I use the Doppler effect when injecting, to watch where the fluid goes. You can see it going into the shoulder joint, or not, better than without it. Same with hips.
If you want to know how good you are at placement of the needle within the joint, you have to do radiology after. I assure you, if you are doing that, you will find you miss some of the time, when you could swear you were in there. I know that because I use US for pre-MRI arthrograms all the time. I had a miss last week. Had to re-inject.
If you want to know how good you are at placement of the needle within the joint, you have to do radiology after. I assure you, if you are doing that, you will find you miss some of the time, when you could swear you were in there. I know that because I use US for pre-MRI arthrograms all the time. I had a miss last week. Had to re-inject.
2014: The year US gets bundled and becomes much less "useful".
and they let CRNA's get reimbursed for ultrasound guided pain procedures injecting knees, hips, shoulders...
that's ok, my machine is paid off.
I don't think ultrasound is used by >50% of outpatient physiatrists. Unless you have one available all the time, you will have to have the patient return for the US guided injection versus doing it blindly on the initial visit.
I don't think so. The ortho lobby is too powerful. If US is bundled then like SIJ, MBB, TFESI, imaging guidance would then be required for joint injections, which the ortho lobby will block, since they are surgical gods who don't need image guidance for any joint injections.
However, in a year or two insurance companies could just decide not to pay for US guidance for knee/shoulder injections. That is more likely.
Local ortho group around here is buying a machine. One of the guys saw me in the hospital the other day and told me about "this cool new ultrasound machine they were getting". I looked at him and said "that is the same machine I bought 18months ago, that you told me was unnecessary!" He looked at me and shrugged his shoulders.
