Is an Ultrasound scan painful? Is it safe?

No, Ultrasound scans are not painful. Ultrasonography is based on sound transmission; ionizing radiation is not used, so it is a safe procedure for the human body.

What are the advantages of an Ultrasound examination compared to other imaging modalities (like CT or MRI)?

Ultrasound imaging, when performed as described above, can be the first and last diagnostic modality in the study of many diseases. The primary advantages of this modality are that it does not burden the body with radiation, does not use intravenous medication and is a patient-friendly examination. Also, Ultrasound is an interactive examination where the patient meets and discusses the symptoms with the doctor performing the scan.

What are the advantages of an Ultrasound scan?

Ultrasonography does not burden the body with radiation. Intravenous agents are not administered and it is a patient-friendly examination. Furthermore, interaction between the doctor and the patient can guide the examination to the area where the symptoms occur and result in a more reliable result. Ultrasound imaging is one of the most important diagnostic tools in Orthopedics, Rheumatology and Neurology, as evidenced in the medical literature.

What is Elastography?

Elastography is a novel technique used in Ultrasound that can measure the elasticity of tissues. It's basic principle is based on the fact that malignant lesions are less compressible than benign, soft lesions.

What is Color Doppler, Power Doppler and B-Flow?

Color Doppler, Power Doppler and B-flow are techniques used to detect vascular flow in organs, vessels and lesions and can depict vascular stenosis or pathologic vascularization (i.e. in malignant lesions).

What is an Ultrasound scan of the upper and lower abdomen?

The upper and lower abdominal Ultrasound scan is used for assessing all non-luminal organs of the abdomen: liver, gall-bladder, biliary tree, pancreas, spleen, kidneys, urinary bladder and internal genital organs (uterus and ovaries in females; prostate in males). 

Ultrasound vascular techniques such as Color, Power Doppler and B-Flow can demonstrate the vascularity of organs. B-flow is a very sensitive vascular technique, which detects even minimal vascular flow inside focal lesions and helps differentiate benign from malignant lesions in the liver, kidneys and pancreas.

Elastography is a useful method in the study of liver in cases of fatty infiltration, fibrosis and chronic liver disease providing classification of liver fibrosis and steatosis.

The large abdominal vessels (abdominal aorta and iliac arteries) are also investigated by Ultrasound and vascular pathology (aneurysms, atherosclerosis) is depicted.

Why is abdominal Ultrasound important in a check-up?

Modern Ultrasound with the aid of novel techniques (Elastography, Color Doppler, B-Flow) can assess all the non-luminal of the abdomen with great reliability. It has key role in preventive medicine and check-up, because non-symptomatic, focal lesions in abdominal organs as well as diffuse organ disease can be diagnosed early. The abdominal organs are studied without burdening the body with radiation or injecting intravenous agents. Also, the vessels can be studied reliably without injecting intravenous contrast agents.

What can I have for breakfast in case my appointment for an abdominal Ultrasound scan is in the morning?

You need to drink 2-3 glasses of water one hour prior to your appointment and fast five hours prior to your examination. If you wish, you can consume coffee or tea (without milk) and a rusk.

What preparation does a child need to make for an abdominal Ultrasound?

The preparation is similar to the one for adults. The child needs to drink 2-3 glasses of water one hour prior to the appointment and fast four hours prior to the appointment.

What is a Breast Ultrasound scan?

Should I present my previous mammography scan report and films to the doctor who will perform the Ultrasound scan?

Breast Ultrasound scan is one of the most important examinations used in the screening for breast cancer both in young women, due to the lack of ionizing radiation, and in women with dense breast parenchyma. In most countries, Ultrasound has been included in the Screening program for breast cancer. Ultrasonography with new generation Ultrasound machines can provide a very good analysis of the breast architecture. Elastography can reveal the elasticity of lesions (soft or hard) which usually correlates with their nature (benign or malignant). Color, Power Doppler and B-flow are techniques that detect the vascular flow in the lesions which is also related to their nature. Breast Ultrasound includes the examination of the axillary areas. In the axillary areas we check for the presence of lymph nodes and with the help of elastography we can characterize them as benign or malignant.

Bringing your most recent mammogram results with you is crucial, as the doctor will be guided to focus on specific areas of interest and correlate US findings with mammography findings.

What is a Thyroid Ultrasound scan?

A Thyroid Ultrasound scan with new generation Ultrasound Systems provides a better analysis of the thyroid gland when looking for diffuse disease (i.e. Hashimoto thyroiditis) or focal lesions (thyroid nodules). The Thyroid gland study with the use of B mode, Color Doppler and Elastography can safely lead to an accurate diagnosis relating to the nature of a lesion (benign or malignant). At the same time the neck area can be scanned to investigate for lesions in the parathyroid glands or enlargement of the lymph nodes of the neck.

What are the pathologies that can be diagnosed with Musculoskeletal Ultrasound?

With Musculoskeletal Ultrasound various pathologies can be diagnosed such as:

• Tendon tears
• Tendinopathies in various anatomical areas (shoulder, elbow, wrist, hip, knee, ankle tendons including the Achilles tendon)
• Muscular sprains
• Muscle masses and hematomas
• Fluid effusion or synovitis in joints in the context of inflammatory arthritis (Rheumatoid Arthritis)
• Investigation of nerve entrapment syndromes (i.e. carpal tunnel syndrome), nerve injuries, neurinomas
• Soft tissue masses, such as lipomas, ganglia, neoplastic lesions

What are the advantages of the Musculoskeletal Ultrasound?

Musculoskeletal Ultrasound is a new imaging modality in the examination of the peripheral joints and tendons of the body. Ultrasonography can, in many cases, replace and offer more information compared to other imaging modalities, such as X-Rays, CT or MRI thanks to its dynamic nature (dynamic maneuvers, ability to detect pathology during movement). Ultrasound scans can be performed in all patients including those who have contraindications to have an MRI scan (i.e. patients with pacemakers or metal hardware).  Ultrasound is a real- time exam, which means that the accuracy of the diagnosis depends on the skills of the examiner and is reached at the time of the examination.

Is Ultrasound useful in the diagnosis of abdominal wall hernia?

Herniae may not be distinct when the abdominal wall is at rest. The Valsalva maneuver (increased abdominal pressure induced by the patient) allows the diagnosis of a femoral or inguinal hernia, linea alba diastasis and umbilical hernia and can be clearly visible with Ultrasound.

What is the procedure for an Ultrasound-guided interventional procedure?

Ultrasound guidance when performing interventional procedures is the most modern and safe technique and is used

• for diagnoses
• for therapeutic purposes

With Ultrasound guidance we can monitor the needle so that the injection is performed

• in a safe and accurate way
• avoiding vital organs such as blood vessels and nerves.

Moreover, with Ultrasound guidance we can guide the needle exactly where it is necessary to inject the therapeutic agent or to aspire fluid for diagnostic purposes.

When is therapy for calcific tendinopathy suggested (Barbotage)?

Calcific tendinopathy is caused by the deposition of calcium crystals (hydroxyapatite) usually in the rotator cuff tendons of the shoulder. There are different stages of the disease. The reabsorption phase when the calcification liquefies is very painful. At this stage Ultrasound-guided lavage of the calcification (barbotage) can be performed with a minimally invasive treatment technique with very good results.

What is PRP?

A Revolutionary Treatment for Chronic Injuries

Laboratory studies have shown that the increased concentration of growth factors found in platelet-rich plasma (PRP) accelerates the healing process in sports - related and musculoskeletal injuries as well as in degenerative arthritis. PRP treatment accelerates rehabilitation and return to sports as well as pain relief in patients suffering from arthritis.

When is PRP performed?

Conditions where PRP treatment is indicated:

• Rotator cuff tendon tears in the shoulder (especially partial thickness tears)
• Epicondylitis of the elbow (tennis elbow, golfer’s elbow)
• Muscle sprains
• Tendonitis (e.g. patellar tendon, Achilles’ tendon)
• Plantar fasciitis
• Ankle sprains
• Early stages of osteoarthritis

What is the procedure of PRP therapy?

The procedure is described below:

• Blood sampling is collected from the patient and is centrifuged, a procedure during which the red blood cells, platelets and plasma are separated
• Platelet concentrate is used for treatment
• Dry needling of the tendon performed under Ultrasound guidance at the same time and prior PRP injection ensures optimal treatment results

When is hydro-dilatation for adhesive capsulitis (frozen shoulder) performed?

Adhesive capsulitis (frozen shoulder) is a condition characterized by limited shoulder movement and pain due to adhesions and narrowing of the joint space. Risk factors are diabetes, thyroid disease, previous surgery and coexisting pathology of the shoulder such as tendon tears, calcific tendonitis.

The condition is self-limiting but recovery can take up to 1-2 years. The hydro-dilatation of the joint can be performed under Ultrasound guidance and injection of saline and local anesthetic in order to eliminate adhesions. Corticosteroids can also be injected to relieve the inflammation. This process facilitates the restoration of the range of motion. A post-hydrotherapy physiotherapy program can enhance the result.

When is an Ultrasound guided interventional procedure in the subacromial/subdeltoid bursa suggested?

In cases of fluid collection and inflammation in the subacromial-subdeltoid bursa following tendon disease, tear and/or subacromial impingement syndrome, corticosteroids and local anesthetic can be injected in the bursa.

Benefits

• Water dilatation of the bursa
• Anti-inflammatory action
• Avoidance of injection into the tendon (which can cause damage or rupture of the tendon)