Neuromuscular Ultrasound

High resolution ultrasonography allows the clinician to examine peripheral nerves such as median, ulnar, radial, sciatic, fibular, and obtain detailed structural images of them. Dynamic evaluation of nerves in different angles during an extremity movement detects the changes of echostructure in the real time. Focal neuropathies, motor neuron disease, polyneuropathies, muscular dystrophies and myopathies are common neurological pathologies detected by high resolution nerve and muscle ultrasound.

Navigational capabilities of ultrasound in the Interventional and Regenerative medicine has approved by medical and surgical communities. Whether it’s come to Myofascial Pain Syndrome, Trigger Point localization, PRP injection, Hydrodissection of pinched nerve root, Radiofrequency or Cryoablation of peripheral nerves ultrasound guidance has been approved as an essential tool for a specialist.

Nerve ultrasound is an anatomical evaluation of the peripheral nerves whereas electrophysiological studies of the nerves such as NCV and EMG are considered physiological. Magnetic Resonance Imaging (MRI) allows detailed imaging of peripheral nerves and their pathology. However, MRI is costly and time-consuming method of nerve mapping that only provides static imaging. Nerve ultrasound is an alternative imaging method for localization and examination of peripheral nerves. Nowadays ultrasound guided nerve blocks are used before and during physical therapy. Therapeutic courses of ROM improvement are better tolerated after ultrasound-guided therapeutic pain injections and nerve blocks. With pain relief the patient will get improved motility of extremity. That means adequate physiotherapy and limb-strengthening exercises can be carried out.

Arterial, Venous Ultrasound

Arterial and Venous studies of lower extremity – doctors order these tests in: pain, cramping, tingling and swelling of lower legs; varicose dilatation of veins, skin thickening and darkening. Dupplex sonography is a first line diagnostic and confirmative test for deep venous thrombosis (DVT). This pathological condition is very dangerous and is not rare after surgeries of legs and pelvic organs such as total knee replacements or radical prostatectomy for prostate cancer. If not recognized by Doppler ultrasound and prevented effectively, DVT of legs may cause venous thrombi to break off to form pulmonary emboli.

Swollen legs, pain and numbness during a physical activity, skin discoloration or thickening in lower legs – these are common medical conditions. Duplex examination of arteries and veins is of medical necessity to find an atherosclerotic plaquing and stenosis of arteries as well as venous insufficiency or reflux.

Urology

Ultrasound examination is very valuable and sometimes is first line diagnostic tool in urological problems. The ultrasound is very effective in diagnosing urinary stone disease, cysts and tumors.

Prostate enlargement, prostatitis, and mass lesions in the urinary bladder are easily revealed by ultrasound examination. In suspicious prostate cancers, ultrasound is done by transrectal root (TRUS). Testicles are examined by the ultrasound for different conditions: torsion, varicocele, hydrocele, male infertility. Doppler examination of male genitalia has its specific role in diagnostics of impotence and sexual dysfunctions.

Gynecology

Gynecology: female pelvic, uterus and ovaries might be seen by using both transabdominal and transvaginal probes. The transabdominal assessment usually provides overview of the pelvis, whereas the transvaginal ultrasound creates more precise and detailed images, especially in obese women.