Echo-based medical style
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The system used is Canon's high-definition echo and the standard orthopedic echo machine, the HS1
At our clinic, we use echo in a variety of situations. We use it to make diagnoses, to understand pathologies, and to accurately treat injections. And, most notably, we use it to assist in surgery. For diagnosis and to confirm the position and direction of the injection needle, we use a Canon high-definition echo and a Konica Minolta HS1, both of which are known for their image resolution.
In addition, the standard probes used in orthopedic practice18Mhz high-frequency probeIn addition to the24MHz ultra high frequency probecan be used.0.1With a resolution of mmBecause of,The images are more subtle than those of normal echoes, allowing for a safer and more reliable surgical procedure.The 24Mhz ultra-high definition probe has only been introduced at the university hospital level,Kagawa PrefectureThe company is one of the few medical institutions using the same probe in
What these echoes have brought to the practice of orthopedics is very revolutionary. By being able to see many things, we are now able to perform with greater certainty what was previously impossible or uncertain. Let's take a peek into this new world.
What do you see in the echo?
Echography has long been used in internal medicine and obstetrics and gynecology. However, it was considered unskilled in relatively shallow areas. Recent technological advances have made it possible to see shallow areas (recently, some probes are capable of imaging within 1 cm of the subcutaneous area with high definition).
Unlike X-rays, which basically depict only bones, echoes excel at soft tissues such as tendons, muscles, ligaments, cartilage, nerves, fat, and connective tissue.
Overlooked fractures are visible.
In fact, echo is now better at detecting small fractures, rib fractures, and other fractures that were missed by x-ray.
Especially in pre-growing children with high cartilage content, the detection of cartilage-containing fractures that do not show up on x-ray by echo plays an important role in determining the course of treatment.
Pain appears to be visualized.
Furthermore, the development of a technique called Doppler echocardiography, which evaluates blood flow, has made it possible to image minute, slow blood flow. We know that pain in chronic disease originates from blood vessels. The depiction of this slow blood flow coincides with the blood vessels that are emitting pain due to chronic disease, thus allowing us to accurately depict the area of pain. These slow-flowing blood vessels that are producing chronic pain are known as "moyamoya vessels. It has been shown that eliminating moyamoya vessels can relieve pain, and our clinic offers a new treatment for "moyamoya vessels" using echo for patients who do not improve with normal treatment.
I can see the nerve.
The high-definition echocardiography system installed in our clinic can even delineate the nerves of the fingers. Now that the nerves can be visualized, it is also possible to visualize pain of a neural origin in addition to vascular pain. Hydrolysis, which will be discussed later, has now gone one step further and neuro (nerve) release is now performed. In our clinic, we also actively release nerve pain of upper and lower extremity and some spinal origin.
In addition, nerve blocks, which are performed during surgery and treatment, can now be performed almost reliably, and the benefits have been enormous.
Visible muscle, tendon, or ligament damage
Injuries to muscles, tendons, and ligaments that could not be seen on X-rays have until now had to rely on MRIs. However, MRI had disadvantages such as high cost, time-consuming, inability to move the patient, and inability to take a second scan immediately. Echocardiography offers the advantages of low cost, immediate examination at the time of consultation, and the ability to move the patient while examining him or her, all of which MRI did not have. We are able to diagnose ligament injuries of the toe, Achilles tendons, shoulder tendons, elbow ligaments and tendon attachments, and leg sprains immediately upon examination, allowing treatment to begin immediately without an MRI, while still allowing for repeated examinations during follow-up, It is easy to visit our clinic.
Tissue stiffness is visible.
Echocardiography can now evaluate muscle and tissue stiffness that could not be evaluated before. High-definition echo is now able to perform shear wave elastography, which is a highly reproducible method of evaluation. This method is particularly effective in determining the timing of return to work for athletes. It is also used to evaluate the stiffness of muscles and Achilles tendons after surgery.
I can see the needle tip of the injection.
Until now, echo was an examination instrument, but now it is also used as a treatment instrument. Most injections have been blind to the needle tip, but our clinic uses echo for the treatment of almost all injections. Whether the needle tip is placed in a joint, close to a nerve, in the site of a calcified tendon, or in an area of muscle stiffness. Already, injections are becoming so difficult to do without echoes. Safer and more accurate. Echocardiography certainly contributes to the accuracy of treatment.
Use as an assist in surgery
The most distinctive feature of our clinic's use of echo is that we also use echo in surgery. Endoscopic and robotic surgeries have been used to reduce the size of surgical wounds and minimize pain during and after surgery. However, the use of echocardiography in surgery is still not common. At our clinic, we have pioneered the use of echo-guided surgery by physicians with overseas experience. We believe that the benefits to patients are great because the surgery can be performed with very little incision. For more information, please refer to the link on our website.
Responsibility: Dr. Yuki Toya, Orthopedic Surgeon, Hand Surgery Specialist/Supervisor
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