Children's Hospital Colorado

‘X-ray Vision’ Machine Saves Time and Money for Orthopedic Patients

An ultrasound on a child's knee

Pediatric primary care sports medicine physician, Gregory Walker, MD, and pediatric orthopedic surgeon, Stephanie Mayer, MD, are excited about the doors a new musculoskeletal ultrasound machine opens for their medical practices at Children’s Hospital Colorado.

The average person might associate an ultrasound machine with pregnancy, because it’s used to produce those black-and-white pictures of a baby inside its mother’s womb. But at the Sports Medicine Center at Children’s Colorado’s Orthopedics Institute, Dr. Walker and Dr. Mayer use orthopedic ultrasound to get a better look at abnormalities or injuries of the musculoskeletal system — bones, muscles, cartilage, tendons, ligaments, joints and other connective tissue.

A cost-effective and time-saving technique

Musculoskeletal ultrasound machines are becoming an increasingly popular tool for orthopedic specialists, especially when it comes to diagnosing injuries in young athletes. That’s because it’s a cost-effective alternative to MRI or CT, it often provides more information than those tests can and it’s a quicker process, says Dr. Mayer, who uses the ultrasound as an extension of her physical exams.

“Although it doesn’t replace an X-ray, it’s like having X-ray vision for many conditions,” says Dr. Mayer. “And that’s a huge advantage to us. It improves the accuracy of the diagnosis.”

“An ultrasound can help you find important areas of inflammation or calcification,” she adds. “And we can do that on the spot in our clinic, without having to send the patient to other parts of the hospital. We can also go through a range of motion and watch to see if there’s a structural tear. You can’t really do that with MRI, since a patient has to be still for that exam.”

Convenience is also a benefit. It’s a portable musculoskeletal ultrasound machine on wheels, and it doesn’t take up much space. It’s approximately 2 feet wide and long and stands at about 5 feet tall.

That’s key for Dr. Walker, because he hopes to one day purchase a similar machine to take off-site to sporting events where Children’s Colorado has a community partner presence. This will allow him to provide ultrasounds for young athletes, moments after they experience an injury.

Ultrasound-guided injections

“There are two primary ways we use an orthopedic ultrasound machine when it comes to the musculoskeletal system,” says Dr. Walker. “We use it for diagnostic purposes, such as identification of injuries like muscle, tendon and ligament tears, but it’s also a great tool for guided injections.”

Ultrasound-guided injections allow a medical practitioner to see a needle in real time as they place it into the body. These types of injections help the practitioner ensure the medication will be inserted in the correct place.

To demonstrate this process, Dr. Walker plugs the machine in and turns it on. He opens the bottle of ultrasound gel, squirts it on his left wrist and rubs it around with the ultrasound probe. Shapes instantly appear on the screen, although it’s hard for an untrained eye to know what they are. But Dr. Walker moves his fingers around, which in turn makes the shapes on the screen move, and he explains.

“You can see real-time movement,” he says. “What you’re seeing now is a cross section of the tendons in my wrist. This is my radius bone, there’s my ulna bone, and then here we’re starting to see the cartilage overlining the ulna bone. We can even get a view of blood vessels, so when we’re doing injections, we can make sure to avoid those vessels.”

It's a pretty neat process.

Both Dr. Walker and Dr. Mayer look forward to providing a more meaningful and interactive appointment experience for patients and their families. They also hope to educate primary physicians about the benefits the ultrasound machine provides and why those physicians should refer patients and their families who need more in-depth, yet cost-effective, pediatric orthopedic care to Children’s Colorado.

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