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    • 3 min read

The Power of Ultrasound Imaging & Ultrasound Guided Injections

Dr. Samuel G Oltman, ND, RMSK


Today’s technology in musculoskeletal ultrasound allows for an incredible amount of information to be obtained in-office at your doctor’s visit without wait time or radiation. Ultrasound is on the cutting edge of orthopedic imaging techniques yet is still not widely used. This becomes even more important when considering injecting medicines for treatment: Why would you not want there to be precise, high resolution guidance showing the exact location of the medicine? Ultrasound imaging and ultrasound guided injections are just one of the many examples in which Cascade Regenerative Medicine sets itself apart. 


Ultrasound imaging and ultrasound guided injection

Advantages of Ultrasound Imaging in Orthopedics: 

  • Non-Invasive: Ultrasound doesn't require any surgical incisions or invasive procedures. This makes it safer and more comfortable for patients compared to techniques like arthroscopy or MRI.

  • Real-Time Imaging: Ultrasound provides real-time imaging, allowing the physician to visualize structures like tendons, ligaments, muscles, and joints dynamically. 

  • Cost-Effective: Ultrasound imaging is generally more cost-effective than other imaging modalities like MRI or CT scans. 

  • No Radiation Exposure: Unlike X-rays and CT scans, ultrasound imaging does not involve any ionizing radiation. This makes it a safer option, allowing for repeated imaging studies over time for before and after comparisons. 

  • Dynamic Assessment: Ultrasound imaging allows for dynamic assessment of musculoskeletal structures, useful in evaluating conditions such as tendon injuries, joint instability, or muscle tears, where dynamic imaging can provide valuable insights into the extent and nature of the injury.

  • High-Resolution Imaging: Advances in ultrasound technology have led to improvements in image resolution, allowing for better visualization of soft tissue structures and subtle abnormalities. This high-resolution imaging capability enhances the diagnostic accuracy of ultrasound in detecting orthopedic conditions.

  • Guidance for Interventions: Ultrasound can be used to guide various orthopedic interventions, including prolotherapy, perineural treatments, PRP, and MFAT. The real-time imaging capabilities of ultrasound allow for precise needle placement, increasing the accuracy and effectiveness of these procedures while minimizing the risk of complications.


(1) Ultrasound imaging of the hip. (2) Labeled anatomy. (3) Needle path.


(1) Ultrasound imaging of the Achilles tendon. (2) Tendon outlined in orange. (3) Possible needle paths.


The biggest downside to ultrasound imaging is that it is highly “practitioner dependent”, meaning that the usefulness of the imaging depends a lot on who is doing it. For you, the patient, what this means is that seeing a physician that has just done a weekend training is not reliable. You need to see someone who has an adequate depth of knowledge and experience, which is what my RMSK credential assures. I have studied musculoskeletal ultrasound for 5+ years totaling thousands of hours and hundreds of patients. My scans mean more than others. 

MD/DOs do not receive in-depth training as a default regardless if they’re sports medicine specialists. It is something that must be sought out independently of training in most cases. The RMSK is the best indicator of expertise and there are only a few in the entire region. 


There is no doubt ultrasound imaging valuable (1). There is no doubt ultrasound guided injections increase accuracy (2,3). There is simply no excuse for your provider to be injecting blind today. Why accept anything less for your care? I worked to become an expert in musculoskeletal ultrasound because I am dedicated to providing the best non-surgical orthopedic care possible. If you are struggling with pain and are not receiving this level of care, come see the difference and schedule today at Cascade Regenerative Medicine.



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