This is yet another great example of how imaging, specifically Ultrasound, can be used to diagnose and treat a common condition seen in runners.
Spring is here and runners, tennis players, golfers, roller bladers and other fitness enthusiasts will be out in full force. Unfortunately, many will likely experience aches and pains from too much activity or improper training, equipment or both. One condition that many runners seek treatment for is associated with a painful bump on the back of the heel, caused by the back of the shoe consistently rubbing against the heel. Often mistaken for tendonitis, superficial irritation or inflammatory arthritis, the proper diagnosis of this condition, Haglund's syndrome, is essential in order to ensure that patients receive the appropriate treatment. Radiologist Dr. Ronald Adler, Chief, Division of Ultrasound and Body CT, and his colleagues at Hospital for Special Surgery in New York City, have used ultrasound technology to both accurately diagnose and relieve the pain of Haglund's syndrome. Once the diagnosis is confirmed, Dr. Adler and his team use ultrasound to guide an injection of anesthetic and steroids directly into the affected area, thus delaying and, in some cases, eliminating the need for surgery. "Patients often feel better from the anesthetic, which usually lasts several hours," said Dr. Adler. "A more prolonged response usually begins two to three days following the injection, once the steroids kick in. An ultrasound-guided injection allows us to directly target the painful area or bursa, thereby avoiding an injection into the tendon. This is the real advantage of ultrasound, since blind injections into the tendon can further weaken it, predisposing the tendon to rupture." A surgical option may also have been considered requiring longer rehabilitation, with several months of restricted activity (aka - no running). "Using ultrasound technology as a diagnostic and minimally invasive treatment for Haglund's syndrome, many individuals can get pain relief without having to undergo surgery," he said. "Ultrasound is a nonsurgical outpatient procedure that does not require sedation and, when used in conjunction with modifications in footwear and activity, is an appropriate initial treatment for relief of the pain associated with this condition." stated Dr. Adler.