Global Musculoskeletal Ultrasound Conf. MUSoc2015 starts October 8

Ultrasound will probe Hidden Injury in Bones & Joints

New Delhi, September 7:  The urgent need and usefulness of ultrasound was underlined in a recent case of a boy of Delhi losing his limb in absence of timely investigation of injury in the muscle.

This was revealed by Dr. Ajay Lekhi, President, Delhi Medical Association (DMA) in the press conference of Musculoskeletal Ultrasound Society (MUS) to emphasize the utmost usefulness of Ultrasound in probing the hidden lesion in bones and joints. A 4 day International Musculoskeletal Ultrasound Conference named MUSoc2015 is being organized in Delhi starting from 8 October to underline the immense usefulness of high frequency ultrasound in the diagnosis of various damages in bones and joints.

Dr. Lekhi was one of the members of Delhi Medical Council Committee which punished four doctors for negligence in this leg amputation case. Dr. Lekhi disclosed that though doctors were made a scapegoat, it was in fact not a case of medical negligence. ‘It was a case of ultrasound not being available for probe. Had ultrasound been applied in this case, the limb of the 10 year old boy could have been saved,’ he held. In the said case, merely a piece of glass had pierced boy’s foot which ultimately resulted in the amputation.

MUS members said Ultrasound might be looked at as villain of the piece for being misused in girl feticide but its various useful applications cannot be underestimated. Ultrasound application has immense use in treating bone and joint damages.

MUS members underlined it quite often happens that in the event of a pathology of bones and joints, basic investigation of X-ray does not detect any injury and, due to multiple reasons, a conclusive diagnosis is not reached. In certain types of injuries, especially in cases of children and elderly, with very osteoporotic bones, X-rays fail to identify fractures, which leave both the patient and doctor at their wit’s end.

In such situations, a doctor has to rely on higher modalities of CT and MRI, which are not only expensive for the patient but many a time, uncomfortable and hazardous too.  High frequency Ultrasound has come as a boon for such and many other conditions in evaluation of bones and joints.

In west, Ultrasound is already a very effective tool in properly diagnosing bones and joints lesions for effective repair. In India too, it is catching up fast. Radiologists in India too are using ultrasound of higher frequency to identify fractures, ligament tears, bending of bones et al.

This has especially emerged useful in  those patients who are claustrophobic and do not want to get into CT or MRI machine holes as well as in those who cannot be prescribed MRI due to presence of pacemakers, implants, etc.

Dr Nidhi Bhatnagar,  MSUS Specialist Radiologist at Sanjeevan Hospital  and Organising Secretary,  MUSoc2015, said ‘Musculoskeletal Ultrasound addresses two major issues in diagnostics today, cost-effectiveness and ease of  availability. It is a very effective complimentary dynamic multi-planar modality to other existing cross-sectional modalities and has its firm advantages and applications in the evaluation of MSK pathologies.  If an Ultra-Sonologist is equipped and has the necessary know-how, he can easily perform a Musculoskeletal Ultrasound to give accurate diagnosis.’

Dr Dhananjay Gupta, Sr Arthoscopic and Joint replacement surgeon and Secy, Delhi Orthopedic association said, ‘Many of my patients have got implants or prosthesis inside their body, which makes it difficult  for them to have an MRI. Such problems also exist with cardiac patients with stents, pacemakers. Musculoskeletal Ultrasound is the only alternative available for diagnosis in such patients. Moreover, children have soft bones, which don’t break but bend with an injury. This bend may not be appreciated on an MRI, but can be easily diagnosed with an MSK USG with less time, money and effort.”

On the use of this modality Dr Sudhir Gupta, leading Radiologist, CEO Cygnus Group of Hospitals and President elect Delhi State IRIA said, ‘This modality is and has been a routine investigative tool in  the US, for  past 20 years It  is relatively  a new concept  in India, primarily due to lack of awareness  not only amongst the patients but also amongst Medical community. Since the clinicians and orthopedicians thought of it as a myth, radiologists found themselves on a back foot too. To summarize, MSUS is   an important investigation  providing  valuable information at much less a cost, being non-radiation dependent, has ease of operability and availability , gives quick results, can perform multiple simultaneous evaluations should need be in the same sitting, multiple reviews without fear of harmful effects, no sedations, no contraindications and above all  a fantastic modality in  emergency conditions.’

Dr. Rajesh Gothi is firmly of the opinion that Ultrasound should be a tool like an extended stethoscope and the applications should be widely applied to all specialties. The maximum benefit is delivered only when a modality is not restricted and is utilized at every stage of learning.’