In April, David and I attended an excellent course in the use of ultrasound for certain of our injection techniques. It is always good to attend these reviews which add to our ultrasound training and we also meet interesting people for an interchange of ideas in the world of musculoskeletal pain. This one was held at the University of Toronto and run by Dr Philip Peng, professor in Anaesthetics and Pain Management at U of T, and his team. Attendees were largely anaesthetists involved in pain management, but I am pleased to report there were at least 5 physicians present who use prolotherapy, helping to spread the word of this remarkable therapy to the wider medical community. This also shows that some prolotherapists are embracing the use of ultrasound guidance for certain of their injections - it is not necessary to use ultrasound but it is very helpful for certain areas of the body. Below you can see Dr Peng, and also a bonus: we met Anne Agur who for 30 or more years has been the illustrator of the famous medical atlas, Grant's Anatomy. She is a delightful and humble lady who is Professor of Anatomy at the University of Toronto.
Ultrasound is a little like computers: someone thought there would only be about 7 computers in the world, each occupying a full room. Think how technology has changed to the world of watches, iPhones, iPads and laptops everywhere! Ultrasounds used to be big machines in hospitals for radiologists (X-ray docs) to help make medical diagnoses like gallstones and heart function. Today they are used in many areas of medicine by many types of physicians: in the emergency room, for obstetrics, for heart disorders, abdominal complaints, and more recently in the field of musculoskeletal medicine, to diagnose muscle tears, joint degeneration/arthritis, fluid in the tissues like a knee Baker's cyst, and for many other reasons. Even better, we can use ultrasound to guide injecting into certain areas of the body, as seen above in the case of shoulder bursitis. Don't worry, the needle is quite magnified in the image above, and some local anaesthetic makes this procedure quite tolerable!
Jannice is a family physician with an interest in the treatment of pain. Anything to help the process is added to this blog.