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From Sports Injuries to Arthritis
Ultrasound Guided Injections Provide Relief

When you�re a seasoned athlete, you want nothing more than to be at the top of your game at all times. Yet with any sport, no matter how skilled the player, there is always potential for injury.

Twenty-three-year-old Tyler Burton of Syracuse, NY, transferred to Adelphi University in 2007 on a full scholarship for lacrosse. Tyler, who has played the sport competitively since the fifth grade, quickly made his mark on the team as a skilled midfielder. But all it took was one quick move during practice his senior year for Tyler to find himself in excruciating pain.

�As I turned to shoot the ball, I felt something pop,� recalls Tyler. �I continued to play through the practice but the pain in my side grew so intense, to the point where it hurt just to walk or sit.�

After seeking evaluations from various specialists, Tyler heeded the advice of Mark Grossman, MD, Chief of the Division of Sports Medicine at Winthrop-University Hospital � the first specialist to diagnose him with a sports hernia � and went to see Jonathan Luchs, MD, Director of Musculoskeletal Radiology at Winthrop, for a follow up evaluation and treatment.

Dr. Luchs is the Director of Winthrop�s Radiology Residency Program and is the Medical Director of Winthrop Radiology Associates � an outpatient facility where patients receive the highest quality imaging services in a comfortable, state-ofthe- art suite. Board certified in diagnostic radiology, Dr. Luchs completed a fellowship in musculoskeletal radiology at the Hospital for Special Surgery and is one of just a handful of Long Island radiologists trained in and practicing musculoskeletal imaging and intervention.

�Ultrasound is a safe and effective way to examine the musculoskeletal system of the body to detect problems with muscles, tendons, ligaments, joints and soft tissue both with static and dynamic imaging techniques without the need for x-ray radiation,� said Dr. Luchs.

�Many patients come in anxious and in a lot of pain and leave saying, �What a relief! That was much easier than I expected!�� said Donna Vedrin, RN, Nurse Coordinator at Winthrop, who has worked closely with Dr. Luchs for three years. �And, with just a little bit of down time afterwards, the results can be tremendous.�
Utilizing high resolution dynamic ultrasound, Dr. Luchs treats a variety of common musculoskeletal conditions including any and all joint pain such as sacroiliac joints, tendonitis, bursitis, neuritis (in particular ulnar neuritis at the elbow), and performs cyst aspiration and injections via ultrasound guided injection. In this procedure, a combination of medication and anesthetic is administered directly and precisely to the site of the pain.

�Ultrasound guided injections can provide long-term relief and potentially a cure for tendon related problems when used in combination with physical therapy,� notes Dr. Luchs. �Yet, for arthritic joint related pain, the relief is temporary. And, in a healthy young joint, we are cautious not to administer more than three injections in order to prevent damage to cartilage.�

Performed on an outpatient basis in less than one hour, the procedure involves a thorough examination of the patient, after which Dr. Luchs administers anesthetic and targeted treatment to the site of pain as it is visualized in real time by a high resolution dynamic ultrasound machine.

�Musculoskeletal ultrasound has many advantages including live action imaging which shows movement, function and anatomy and enables me to pinpoint the source of pain and treat it effectively,� said Dr. Luchs. �What�s more, the procedure is minimally invasive and refrains from exposing patients to ionizing radiation.�

�Many patients come in anxious and in a lot of pain and leave saying, �What a relief! That was much easier than I expected!�� said Donna Vedrin, RN, Nurse Coordinator at Winthrop, who has worked closely with Dr. Luchs for three years. �And, with just a little bit of down time afterwards, the results can be tremendous.�

Dr. Luchs treated Tyler for his lacrosse injury with an ultrasound guided steroid injection in the tissue at the muscle attachment to the pelvis along the anterior wall of the abdomen.

�Dr. Luchs was extremely thorough during the exam and targeted the exact spot where I was experiencing pain,� recalls Tyler. �The entire procedure was quick and thanks to Dr. Luchs, I was able to get back on the field in no time with far less pain than I had before.�

A series of three ultrasound guided injections over the course of several months also provided relief to Grace M. who suffers from a degenerative right hip. Characterized by sharp spasms in the groin, the pain had become increasingly severe making it difficult for Grace to walk or turn over in bed.

Grace, who also suffers from arthritic knee pain, consulted with her orthopaedist, Omid Barzideh, MD, who referred her to Dr. Luchs for an evaluation of her hip pain. Dr. Luchs performed an MRI which revealed osteoarthritis � a degenerative condition characterized by the breakdown of cartilage in the joints.

�The basic understanding of steroid use in osteoarthritis is that it treats the pain and secondary inflammation associated with the arthritis, but does not stop the progression of the condition,� said Dr. Luchs.

�Injections in patients with severe osteoarthritis are usually putting off the inevitable � a joint replacement � or in some cases, are treating a patient that is not an operable candidate for other medical reasons.�

Grace received her first ultrasound guided injection just before leaving for a much-awaited vacation to Mexico.

�Dr. Luchs and the nursing staff were wonderful and extremely thorough. I achieved great relief from the injection and was able to enjoy my vacation � walking the beaches and riding a bicycle free of pain!� Grace�s sharp spasms and pain gradually returned and just a few months later, before heading upstate for the summer to fulfill her job responsibilities at a large sleep away camp for children, Grace turned to Dr. Luchs once again.

�I didn�t want to take any chances knowing that I�d be several hours from home and there�d be a lot of stairs to climb and walking to do,� said Grace. �That injection enabled me to successfully get through the summer pain-free and I was so thankful!� For Grace, the ultrasound guided injections, although not a permanent solution to her pain as she expects to undergo hip replacement surgery later this year, not only provided temporary relief from excruciating pain but also another important advantage � time.

�Surgery is a big decision,� she said, �one that must be carefully considered. Ultrasound guided injections treated my pain effectively and alleviated any pressure to make such an important decision too quickly.�

Yet, surgery isn�t always the answer for some patients. Robert Kormendi, MD, a family physician from Queens, understands what that�s like.

Dr. Kormendi, who suffers from debilitating knee pain associated with arthritis, underwent surgery a few years ago to remove a baker�s cyst � a collection of fluid in the back of the knee joint. Doctors advised him that the cyst would recur, but Dr. Kormendi was desperate for solution to the pain.

The cyst indeed returned and upon recently bringing it to his orthopaedist�s attention, Dr. Kormendi was referred to Dr. Luchs for treatment. Dr. Luchs aspirated the cyst and using ultrasound technology, administered a steroid injection into the cyst. Dr. Kormendi was first treated in May and relief lasted for four months. He recently received a second injection, for which he is extremely grateful.

�Surgery didn�t solve the problem,� said Dr. Kormendi. �But with ultrasound guided injections, relief from the pain was immediate. I got off the examination table and felt like I was ready to go for a run!�

For more information about the latest musculoskeletal imaging technology and techniques at Winthrop, call 1-866-WINTHROP.
Vol. 19, No. 3
Fall 2009

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