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Ultrasound Push Focuses On Sports Injuries

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It’s faster, much cheaper, often safer, and in many situations just as accurate. So why does ultrasound typically take a back seat to X-rays, MRI, or CT for sports medicine?

Advocates for ultrasound asked that question earlier this week at the Ultrasound First Forum in New York, organized by the American Institute of Ultrasound in Medicine. The forum promoted ultrasound use in a variety of medical situations, but some speakers said it was particularly well-suited for sports medicine.

Levon Nazarian, MD, professor of radiology at Thomas Jefferson University in Philadelphia, asserted:

Just about every structure that’s likely to be injured in an athlete, we have some way of assessing it with ultrasound imaging.

Dr. Nazarian was quoted in a DOTmed News account of the forum.

Ultrasound’s portability and ability to image in real time offer particular advantages for sports medicine, Dr. Nazarian and other advocates said. And it’s cheap, especially compared to its main rival, MRI. Still, as Dr. Nazarian said:

Usually we like to do the less expensive test first, but in musculoskeletal, we definitely do the most expensive test first, and we do the less expensive test if indicated.

With all of ultrasound’s advantages, why is it necessary to hold a forum to promote its use? Some insurance plans are reluctant to reimburse for it, especially because for some injuries it tends to produce inconclusive results that require a follow-up MRI. In those cases, the insurers figure, why not skip directly to the MRI?

Ultrasound is also viewed as particularly dependent on the skill of the operator. During a panel discussion at the forum, one audience member said interpreting ultrasound was difficult even for radiologists.

However, as fee-for-service payments yield to bundled or lump-sum reimbursement via accountable care organizations and the like, the appeal of cheaper imaging modalities will increase.

Bill Moreau, DC, managing director of sports medicine for the U.S. Olympic Committee, said the committee in a recent training season performed 284 ultrasounds and only 33 MRI scans. “We feel it’s almost an extension of the physical examination. It’s also extremely cost-effective for us.”

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Related seminar: UCSF Neuro and Musculoskeletal Imaging

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