No patients complained to me about using ultrasound
There are folks out there using ultrasound for no good reasons
what is the point of using ultrasound for trigger point injections??
what is the point of using ultrasound for lateral femoral cutaneous nerve and many of those patients are very obese and ultrasound is time consuming
why are these academic people making these fancy ultrasound workshops and claim their superiority while in the real world, it has no efficacy and most likely will not get reimbursed?!?
academic ultrasound is far from the real world. Oh. I even saw the academic people claiming to see DRG on ultrasound!!! It is great that u see but what are u gonna do with this ?
boomer talk.
when the anesthesiologists first started using fluroscopy for epidurals, their seniors scoffed at them. "did we not teach you how to feel for it?"
then the studies came and showed that they were in the wrong place 30% of the time.
doing US is time consuming? not if you develop the skill and get good at it. just like doing an emg or a physical exam, or a cardiac stent.
far from the real world?
my colleague - US is the next evolution of the stethoscope. there is a reason so many schools have adopted giving US to their MEDICAL STUDENTS.
why listen for what you think is regurgitation when you can look at it and confirm at the bedside? in fact, you can see the cardiac effusion, the valve prolapse, the cardiac wall thickening, fluid in the lungs while you're at it. bedside diagnosis in the right hands can save time, money, and lives.
for physiatrist, where does US fit it?
why obtain an expensive MRI that may take weeks to get approval when a 15 minute comprehensive shoulder exam with US can be just as sensitive for most extra-articular pathology?
and as far as anatomic palpation guided injections, the studies show that even basic knee injections by well trained senior physicians can be inaccurate up to 40% of the time. we simply are NOT as good as we think we are without accountability (visual confirmation, fluro, CT, US)
back to what is part of physiatry - there was a time in the field where people debated on what should be the scope of the field. was it more physical medicine or was it rehabilitation. when rehab stays were 100+ days and our tools were limited to modalities and serial casting. they resolved those internal conflicts and the field evolved. then peopled debated whether or not spine injections or even NCS should be a part of what a physiatrist does. it took people who were interested and motivated to fight for it. to go out and learn it. to develop these skills, bring them back and internalize them into the training. eventually EDx became a core part of the training and likely every single pmr dept has a spine interventionalist.
our field, like everything else continues to evolve. 10-15 years ago it might have been spine injections. today it is ultrasound. in 20 years, it will be something else.
