醫學超聲影像檢驗 Diagnostic Medical Sonography

用於軟組織檢查的新技術

超聲波掃描檢查儀器,能更準確診斷多種筋骨病症。傳統的超聲波掃描顯像,即所謂的「照超聲波」,主要是較低頻的探頭(<7.5MHz)觀察內臟器官毛病,如腎石,膽石等;又或是作婦科檢查,如觀察胎兒狀況。而用於物理治療層面是區別於傳統低頻超聲波級數的高頻探測器以觀看筋腱、肌肉、韌帶、滑囊和部分軟骨等組織結構。

較便宜、無輻射
磁共振以外的選擇

從前用於筋骨疾病的顯像方法,一般是先照X光。然而X光只能看見骨頭情況,如骨折、骨剌等,但不少筋骨痛症其實是來自軟組織問題,如網球肘、肩周炎和足底筋膜炎等。這些毛病在X光下都不能顯示出來。如果要檢查軟組織,以往的選擇就只有照磁力共振﹙MRI﹚。但磁共振費用昂貴,例如單一部位,動輒要四、五千元。現在,超聲波掃描用於筋骨疾病的嶄新技術,就提供了較便宜的新選擇。而且它還具備無輻射,可左右對比和在動態下顯像的新優點。

提高診斷準確性
以作針對性治療

利用超聲波掃描,我們可準確鑑別真正發生問題的軟組織結構。以肩膊痛為例,假如當作一般肩周炎治理,經過長時間的中西療法、服藥、運動等皆無法根治,便應作進一步診斷,而超聲波便可判別出一些較隱藏的病因,例如肩筋脫位、肌腱鈣化、肌腱撕裂或滑囊發炎等,從而對症下藥。臨床上,超聲波掃描能對以下部位作出準確的鑑別診斷:

肩部:如判別不同筋腱病變、滑囊炎等
足底:如判別足跟痛的不同炎症源頭,如足底筋膜、筋腱或脂肪墊
足踝:如判別「拗柴」後長期腫脹、疼痛反復之原因
膝、肘、腕:如判別不同程度的肌腱病變、韌帶損傷或神經壓迫等

 

**『所有檢查及治療方式均有其利弊,詳情請向醫生查詢。』**

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Advanced technology
t
o investigate soft tissue problems

Ultrasound Scan machine for the Diagnostic Medical Sonography (MSK), is able to make an accurate diagnosis of various soft tissue diseases and injuries. Traditional diagnostic ultrasound technique uses a relatively lower frequency (<7.5MHz) mainly to investigate internal organ problems, such as kidney stone, gall stone and fatty liver, or used for gynecology examination and prenatal checkup. However, with this more advanced high frequency transducer (>14MHz), it is able to provide a better view and more accurate diagnosis for soft tissue such as tendon, muscle, ligament, bursa and some of the cartilage.

Inexpensive and non-radioactive
another option besides MRI

For musculoskeletal problems, physicians usually ask patient to take a plain X-ray first. However, X-ray can only show bone problems, such as fracture, osteophyte, etc. Many musculoskeletal disorders are in fact caused by soft tissue diseases or injuries like tennis elbow, shoulder impingement and plantar fasciilitis. Traditional choice to check these soft tissue structures could be MR Imaging, which costs $4,000-5,000 for a single joint. Nowadays the diagnostic ultrasound technique provides another option, which is relatively inexpensive. It is non-radioactive, and it allows a both-side comparison, as well as real time scanning in movements.

Improve accuracy of diagnosis,
find the correct treatment

By using diagnostic ultrasound, we can make differential diagnosis of different soft tissue diseases. Considering the following case: A patient got a shoulder pain which was firstly diagnosed as a common “frozen shoulder”, and he received various treatment accordingly, including medication, bone setting, acupuncture, exercise therapy, etc. However, the pain persists. In such case, he will need a further investigation by the ultrasound scan to make a differential diagnosis of the real disorder, such as muscle rupture, tendon calcification or tearing, and hence to design a more directed treatment plan. Clinically, diagnostic ultrasound is able to make differential diagnosis in different conditions:

Foot: planter fasciitis, fat pad syndrome
Ankle: to find the reason of chronic swelling and persisting pain after ankle sprain
Shoulder: tendon and muscle disorder, bursitis
Knee, elbow and wrist: tendon and muscle disorder, ligament injury, nerve entrapment

 

**『Please be aware that all the assessment and treatment options may have their pros and cons, for more information please seek medical advice from healthcare practitioners.』**

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