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Physicians' Pain and Spine Specialists, PLLC

​​​Sports Medicine

Musculoskeletal Ultrasound and Joint Injections 

 (Knee Shoulder, Elbow, Wrist, Ankle, Carpal Tunnel)

Musculoskeletal ultrasound is the use of a sophisticated ultrasound machine to help guide soft-tissue injections. While fluoroscopy is used for many joint injections or spine injections, the advantage of MSK ultrasound is that it can help guide injections for tendon and ligament injections. It can also be used to diagnose things like rotator cuff tears, tendon, muscle, or ligament tears, and nerve entrapment.

What sets us apart from most clinics is the combined use of sophisticated fluoroscopy techniques and MSK ultrasound. Most clinics use neither, and the few that do use imaging guidance of injections use either MSK ultrasound or fluoroscopy, but rarely the two technologies together. We often utilize both at the same time to en

sure utmost precision.


PRP for Tendon and Ligament Degeneration

Platelet Rich Plasma (PRP) is plasma with more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater than usual.

Many musculoskeletal injuries are mistaken to be inflammatory in nature, and treatment directed at reducing inflammation repeatedly fails. Such injuries are often the result of repetitive damage to the tissues (typically ligaments or tendons), causing decreased blood-flow with degenerative changes in these areas.

PRP preparation involves drawing blood from the patient and then increasing platelet concentration through centrifugation. The increased concentration of platelets is combined with the remaining blood and then injected into the damaged tissue to facilitate new growth of damaged tissue. PRP injections may be aided by the use of an ultrasound guide to pinpoint accuracy and ensure that the solution is targeting the damaged tissue as well as avoiding other structures.

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  •  Injections Viscosupplementation
  • Viscosupplementation injections consist of hyaluronic acid-like fluids which are injected directly into the arthritic joint. Hyaluronic acid is a naturally occurring substance found in the synovial (joint) fluid. It acts as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads.

    Studies have shown that viscosupplementation injections provide significant pain relief in patients with mild to moderate osteoarthritis. Their beneficial effects may last for several months or longer. Currently these injections are approved by the FDA for use in patients with knee osteoarthritis, but research is being conducted in other joints, such as the hip, ankle, and shoulder.

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    Viscosupplementation Injections
  • Prolotherapy
  • Fat Graft Regenerative Injections
  • Blood Derived Stem Cell Procedures