If your doctor uses only x-ray to diagnose a foot or ankle problem, he may be getting only a part of the picture. X-rays reveal the bones, but they do not show the soft tissue including the blood vessels, nerves, muscles, tendons, ligaments and such things as joint capsules. Many of the things that go wrong in the foot do not involve bones, so x-rays illuminate only a partial picture of what is happening. Ultrasound allows us to see much, much more in the foot.
Arbor Foot Health Center is celebrating the arrival of a new, color ultrasound machine. I started using ultrasound imaging to look at the foot eight years ago when it first became practical. Arbor Foot Health Center’s latest color ultrasound machine shows circulation within the structures of the foot and has such excellent resolution that tears in tendons can be easily seen. Ultrasound also reveals tendons’ motion within the foot. The need for an MRI is minimized with the use of ultrasound. Because it doesn’t use ionizing radiation, ultrasound is safer than an x-ray or an MRI.
We use the ultrasound imaging to help in our diagnosis of plantar fasciitis – the most common source of heel pain. By looking directly at the plantar fascia we can determine how swollen it is and give a rough estimate as to how long it will take for the pain to resolve. We can also see if there is a tear in the plantar fascia which may necessitate a different treatment.
Ultrasound imaging is also good for treating Morton’s neuromas. This very painful problem can be more accurately treated if it can be precisely located with the ultrasound. An injection can be performed directly into the neuroma and this is proving to be more effective than the traditional blind injection.
Finally the ultrasound is proving valuable for the diagnosis of stress fractures. While stress fractures are often not visible on x-ray for three or four weeks after injury, they are frequently seen on ultrasound earlier than that. However the FluoroScan also is useful too see small changes in bones that are characteristic of recent stress fractures. Read more about Fluoroscan here.