Ultrasound Treatment Techniques

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Questions and Answers

What is the highest acceptable BNR in the US?

  • 8:1
  • 6:1 (correct)
  • 10:1
  • 4:1

Thermal ultrasound is contraindicated for patients with cancer.

True (A)

Name one thermal indication for using ultrasound treatment.

Pain control

Ultrasound can be used to treat _____ injuries in acute conditions.

<p>tendon</p> Signup and view all the answers

Match the following indications with their categories:

<p>Pain control = Thermal Surgical incisions = Non-thermal Carpal tunnel syndrome = Non-thermal Chronic tendon injury = Thermal</p> Signup and view all the answers

What should be done if the ultrasound treatment results in dangerously high intensity heating?

<p>Pause treatment and lower intensity (B)</p> Signup and view all the answers

Keeping the ultrasound head still is recommended to prevent overheating.

<p>False (B)</p> Signup and view all the answers

What is microstreaming in the context of ultrasound treatment?

<p>Currents occurring around gas bubbles set into motion by cavitation</p> Signup and view all the answers

To enhance healing, ultrasound treatment is often paired with _____ to reduce inflammation.

<p>phonophoresis</p> Signup and view all the answers

Flashcards

US BNR Ratio

The ratio of peak power to average power in ultrasound (US) beams. A 6:1 BNR is the highest acceptable ratio in US procedures.

Thermal Effects of US

Heat-related effects like pain relief, preparing shortened tissues for stretching, healing chronic tendon injuries or calcium deposits.

Non-thermal Effects of US

Effects not related to heat, such as promoting healing of vascular ulcers, treating acute tendon injuries, carpal tunnel syndrome, and surgical incisions. It may also reduce inflammation.

US Contraindications

Conditions where US should not be used, including cancer, pregnancy (certain areas), pacemakers, certain brain tissues, joint replacements, DVT, eyes, sinuses, reproductive organs.

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Microstreaming

Fluid currents caused by cavitation around gas bubbles in tissues, increasing ion permeability and agitating cell membranes.

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Acoustic Streaming

Another fluid current phenomenon related to ultrasonic waves influencing the flow of fluids.

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US Periosteum Effects

High-intensity US can cause periosteum healing issues, so technique adjustments are needed (e.g., lower intensity, faster head movement, larger treatment area ).

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Incomplete Skin Contact

If the treatment head does not completely touch the skin (e.g., due to bony prominences), it leads to high energy concentration and heating concerns.

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US Technique Modification

Modifications in US treatment parameters (e.g., frequency, speed of the treatment head, output energy) depending on patient response, especially for problems such as periosteum healing.

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Study Notes

US Beam Power Ratio

  • Peak power to average power ratio in US beam is relevant.
  • 6:1 BNR (Beam Non-uniformity Ratio) is the highest acceptable level.
  • Improper technique can lead to dangerous heating.

Indications for US Treatment

  • Thermal Effects:
    • Pain management
    • Preparing for stretching of shortened tissues
    • Chronic tendon injuries
    • Calcium deposit reabsorption
  • Non-thermal Effects:
    • Healing of vascular and pressure ulcers
    • Acute tendon injuries
    • Carpal tunnel syndrome
    • Surgical incision treatment
    • Phonophoresis for inflammation reduction

Contraindications for US Treatment

  • Cancer
  • Pregnancy (abdominal or back area)
  • Pacemakers
  • Central nervous system (CNS) tissue (e.g., laminectomy)
  • Joint cement or plastics
  • Deep vein thrombosis (DVT)
  • Over the eyes
  • Carotid sinus
  • Reproductive organs
  • All heating applications are thermal US contraindications

Proper US Technique and Modifications

  • Patient Response: Adjust treatment based on patient response.
  • Errors and Effects (Periosteum):
    • Pause & reduce intensity if needed.
    • Consider changing frequency from 1 MHz to 3 MHz for more superficial treatment to reduce periosteum healing.
    • Adjust treatment head speed and treated area size.
    • Maintaining Contact:
    • Keep treatment head moving continuously to prevent overheating.
    • Maintain even, parallel skin contact to prevent high energy concentration (at periosteum).
    • Use smaller treatment heads for optimal contact, or apply ultrasound with an indirect immersion technique using water.
    • Ensure sound head is in contact with the skin to avoid damaging the sound crystal.

Thermal and Non-thermal Effects

  • Microstreaming: Currents around gas bubbles due to cavitation. Agitates cell membranes and increases ion permeability.
  • Acoustic Streaming: (Not elaborated).
  • Ion Exchange: (Not elaborated).

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