Using Portable Ultrasound for Tennis Elbow Diagnosis

Call us at 281-633-8600.  In this article and video, Dr. J. Michael Bennett explains how he uses portable ultrasound to diagnose tennis elbow and other musculoskeletal issues involving the elbow, shoulder, and the knee.  Doctor Bennett serves patients from Sugar Land, Katy, Missouri City and Houston from clinics in Sugar Land and Houston, TX.

Dr. J. Michael Bennett is a Board Certified Orthopedic Surgeon and Fellowship Trained Sports Medicine Doctor.  We accept Aetna, Cigna, United Healthcare and most other medical insurance plans, and we serve patients from the Metro Houston area through offices in Sugar Land TX.  Dr. Bennett works with his patients to identify non-invasive and non-surgical treatments, when possible.  He specializes in treating chronic conditions and acute injuries affecting the elbow, shoulder, knee, and hand.  Call our office at 281-633-8600 for an appointment.

In this video, Dr. Bennett describes how he uses portable ultrasound as a tool for diagnosing musculoskeletal issues like tennis elbow.  This information is for educational purposes only.  It’s not intended as a substitute for professional medical advice, diagnosis, or treatment.  You should not act upon any information provided here without first seeking medical advice from a physician.

This is a transcript of the video:

Hello, I’m Dr. J Michael Bennett with the Fondren Orthopedic Group.  Today I want to introduce you to the ultrasound guided imaging that we are using for musculoskeletal complaints.  If you think about musculoskeletal injury, many times we get plain X-rays to show us what the architecture of the bone structure is.  And this is to evaluate for fractures or dislocations.  If there was ever a soft tissue question, many times we would rely on our physical exam and if we were suspicious we would order an MRI.  An MRI costs money, requires additional time, plus we have to get the films back at our office for review and have the patient come back and discuss those findings.  

We are now able to bypass some of that cost and time by incorporating musculoskeletal ultrasound, which is a very exciting new realm of evaluation and it’s been helpful incorporating this within our clinic in regards to musculoskeletal issues particularly in the shoulder and the elbow and, occasionally, the knee.  Some of the deeper joints are very hard to evaluate with ultrasound and we oftentimes still need an MRI.  Many times we’ll look first with an ultrasound and then if there’s a question we can always order an MRI to confirm.  But for preliminary screening ultrasound is a great tool to diagnose tennis elbow and other musculoskeletal injuries and right here is a G.E. Logic i and I’ll just show you a couple of pictures of what the ultrasound looks like and what we see when evaluating a patient.  

Okay, so this is the G.E. Logic i, this is our ultrasound probe here, this is the standard gel that we use.  So we have a smaller probe and just for example I will show my elbow today.  All this [pictured on the monitor] is jelly on the probe  and it works by sending sound waves this way and the sound waves bounce off different tissues so when you start looking at the elbow, you’ll have a different intensity based on whether you’re seeing bone, tendon, ligament or fatty tissue.  This here is an elbow joint.  The white outline there is the bone.  And I’m rotating my elbow, back and forth.  And that’s the radial head rotating back and forth on the radial capitellar joint of the elbow.  

A lot of times you can see tennis elbow very clearly using an ultrasound.  You can see defects within the tendon, you can see where the tendon inserts, and right here is a normal looking tendon.  The white line below the tendon is the bone and I don’t see any calcium deposits within the tendon and the tendon looks intact.  With a patient who has a torn tendon, you will see a big black spot in that area where the tendon’s retracted.  So this is very helpful in looking at tennis elbow as well as other maladies of the elbow in addition to the shoulder and occasionally the knee.  

Like I mentioned before, we’re not very good at seeing deep within the joints so we can’t see meniscus tears, or anything in the ball and socket mechanism of the shoulder joint but it’s good for looking at the superficial tendons.  So if you’d like us to evaluate your shoulder with ultrasound evaluation, please let us know at your clinic visit.  If you have any questions regarding this please contact me at my office.  I’m Dr. J. Michael Bennett.  Thank you. 

If you have any questions about this video or any orthopedic or sports medicine issue, please call our office at 281-633-8600 for an appointment with Dr. Bennett.

Dr. J. Michael Bennett

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