Ultrasound advice needed

[Guest guest]

I have a small housecall practice, so I have not had need for a therapeutic

ultrasound (until now). I have a German Shorthair Pointer (50#)who just had

arthroscopic surgery on her shoulder, and the ultrasound will be an integral

part of her therapy, so the owner and I are looking into purchasing one. (there

is not one within a 2-1/2 to 3 hour drive, that we know of)

Any advice on brands or particular units would be greatly appreciated. First, I

would assume that the $100 units (US Pro 2000 portable ultrasound) for sale on

the internet are probably not enough? (just has a 1 MHz probe, and I don't know

if there is any choice as to settings)

I have talked with Chattanooga. They have the Intalect Legend ($1080) or the

Intalect Legend Transport ($975). Both come with a 5cm soundhead, and both have

the option to buy a 2 or 10cm soundhead, plus a 1cm soundhead option with the

Transport model only. Both have 1 and 3 MHz and pulsed and continuous settings.

So my questions are if either of these units from Chattanooga are good, or if

another unit is better for a comparable price. Also, what size probe head we

will need for this dog, so we can order an extra head if needed. It comes with

the 5 cm squared head.

Obviously, I am a novice with the ultrasound, other than what I have done in my

training. The surgeon said that they could help with the protocol, but the

person I need to talk to is gone for another week! The dog had surgery Monday

and ideally will start therapy next week (as soon as the ultrasound comes in).

On Monday, she had ultrasound and arthroscopy of her right shoulder and elbow

after an ongoing intermittent 6 month lameness. This is her findings: right

shoulder adhesive capsulitis (frozen shoulder), right severe osteoarthritis,

right supraspinatus, teres minor, and infraspinatus tendinopathy, right

bicipital tenosynovitis, right elbow severe synovitis and cartilage

irregularity.

The discharge papers recommend manual therapies, continuous ultrasound, +/-

UWTM, and at-home daily exercises.

She has lost ROM on extension, but also flexion and abduction of the shoulder,

thus the diagnosis of frozen shoulder. So I would think I would need to use the

ultrasound to " warm up " the supraspinatus, teres minor, and infraspinatus, then

do stretching. My thoughts on settings (from my class notes)would be 3 MHz at

0.3-0.5 w/cm2 for 5 minutes, " waltzing " from proximal humerus, around the

shoulder, and up onto the scapula. Clipped hair, lots of gel. Do this twice a

week, with owner doing daily PROM.

Any pointers (no pun intended) on the treatment protocol would be greatly

appreciated!!

Thank you, in advance, for your time and knowledge.

Sandy Young DVM, CVA, CVCH, CCRT

[Guest guest]

As far as units go, I think the Chatanooga group is a good choice. They make

human models too of which I use during my human practice.

Depending on what areas you will be ultrasound, will tell what size sound head

to use. A good rule of thumb is that you spend 5-10 minutes per area twice the

size of the sound head. If you are doing a large muscle area, then a 5 cm head

would work, but you may just have to do the treatment for a longer amount of

time. The 10 cm area is probably overkill in my opinion. The 1 cm sound head is

good for smaller areas, or if working around bony areas. 3 MHz is good if you

are staying fairly superficial with what you are trying to accomplish.

Continuous setting for warming the tissues. 0.3-05 W/cm2 seems a bit low to me.

I use 1.0-1.5 W/cm2 typicallly for tissue warming.

I hope that helps!

Day, MPT, CCRP-pending

>

> I have a small housecall practice, so I have not had need for a therapeutic

ultrasound (until now). I have a German Shorthair Pointer (50#)who just had

arthroscopic surgery on her shoulder, and the ultrasound will be an integral

part of her therapy, so the owner and I are looking into purchasing one. (there

is not one within a 2-1/2 to 3 hour drive, that we know of)

>

> Any advice on brands or particular units would be greatly appreciated. First,

I would assume that the $100 units (US Pro 2000 portable ultrasound) for sale on

the internet are probably not enough? (just has a 1 MHz probe, and I don't know

if there is any choice as to settings)

>

> I have talked with Chattanooga. They have the Intalect Legend ($1080) or the

Intalect Legend Transport ($975). Both come with a 5cm soundhead, and both have

the option to buy a 2 or 10cm soundhead, plus a 1cm soundhead option with the

Transport model only. Both have 1 and 3 MHz and pulsed and continuous settings.

>

> So my questions are if either of these units from Chattanooga are good, or if

another unit is better for a comparable price. Also, what size probe head we

will need for this dog, so we can order an extra head if needed. It comes with

the 5 cm squared head.

>

> Obviously, I am a novice with the ultrasound, other than what I have done in

my training. The surgeon said that they could help with the protocol, but the

person I need to talk to is gone for another week! The dog had surgery Monday

and ideally will start therapy next week (as soon as the ultrasound comes in).

>

> On Monday, she had ultrasound and arthroscopy of her right shoulder and elbow

after an ongoing intermittent 6 month lameness. This is her findings: right

shoulder adhesive capsulitis (frozen shoulder), right severe osteoarthritis,

right supraspinatus, teres minor, and infraspinatus tendinopathy, right

bicipital tenosynovitis, right elbow severe synovitis and cartilage

irregularity.

>

> The discharge papers recommend manual therapies, continuous ultrasound, +/-

UWTM, and at-home daily exercises.

>

> She has lost ROM on extension, but also flexion and abduction of the shoulder,

thus the diagnosis of frozen shoulder. So I would think I would need to use the

ultrasound to " warm up " the supraspinatus, teres minor, and infraspinatus, then

do stretching. My thoughts on settings (from my class notes)would be 3 MHz at

0.3-0.5 w/cm2 for 5 minutes, " waltzing " from proximal humerus, around the

shoulder, and up onto the scapula. Clipped hair, lots of gel. Do this twice a

week, with owner doing daily PROM.

>

> Any pointers (no pun intended) on the treatment protocol would be greatly

appreciated!!

>

> Thank you, in advance, for your time and knowledge.

>

> Sandy Young DVM, CVA, CVCH, CCRT

>