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tiahuratoday at 4:58 PM3 repliesview on HN

Why isn’t diagnostic ultrasound used in orthopedics? They inspect fetus hearts and other organs everyday, why not shoulders? Seems much cheaper and faster.


Replies

sxgtoday at 5:04 PM

They do. Ultrasound in orthopedics is a relatively newer field, and there aren't quite as many sonography techs and radiologists experienced in reading these studies, which is likely why you don't see it offered more widely.

Edit: I should mention that ultrasound is basically unusable for evaluating bones. Sound waves can't penetrate bone, and so you end up just seeing a huge black void. That's a huge orthopedics use case that ultrasound just can't benefit. However, ultrasound is fantastic for evaluating muscles, ligaments, tendons, and other superficial soft tissues.

scrolloptoday at 6:18 PM

We order ultrasounds all the time for shoulders (for like soft tissue issues; for trauma, you'd start with an xray). For other joints, such as the knee, MRIs are a better choice (unless htere has been substantial trauma, in which case xray initially or further), though more expensive, unless you're excluding a Baker's cyst, in which case an ultrasound is fine.

Since MRIs are more expensive, private doctor's might order them instead of an ultrasounds.

(I'm a doctor)

bfleschtoday at 6:09 PM

It's a manual, non-standardized process without a standardized output. Image quality depends both on user skills (how deeply they press the sensor on the skin) and the machine they have. Unlike CT/MRI the examination results cannot be easily shared and compared between patients for studies.