12/05/2019    Kim G. Gauntt, DPM

Ultrasound-Guided Injections (Elliot Udell, DPM)

I acquired my first ultrasound some 20 plus
years ago. I learned in workshops to do the
guided injections. The guided plantar fascia
injection is my primary use therapeutically, the
ultrasound is a very versatile imaging modality
diagnostically.

The only way to measure the “effectiveness” is
from what patients tell you who have had both.
Since I don’t inject the fascia without it, my
feedback is from those who have come from other
practices over the years where non-guided
injections had been given and the overwhelming
majority say the result is much, much better.

I don’t do a fascia injection without it. From
the start, many years ago , I believed it was
far better to see where, specifically, I was
with the medication and I firmly believe still
that to be the case for several reasons. Yes,
the medications likely spread in the tissue but
where does it spread from? Did you inject the
muscle, the fat pad or the fascia? Most would
often be surprised as to where that needle
really is if they have never imaged it in real
time.

Prior to imaging I thought I was in the correct
location since my results were typically good,
or so I assumed. When I started guiding my
injections my results were simply better.
Instead of the series of 3 we used to routinely
give ( as we were taught) I rarely give more
than the one initial.

Perhaps some of the potential negative effect of
the cortisone is reduced by confirming the
location of the injectable. Perhaps one would
find that a lesser dose is required for the same
or better effect (which has been my experience).

Over the years I learned what a “normal” fascia
should look like and what “average” thickness
should be and I established parameters and
protocols for when I would inject and when I
would not. I established those numbers as I
scanned any one who would let me, both those
with symptoms and those without, normal and
abnormal.

At the APMA National meeting this year in Salt
Lake there was an ultrasound workshop, a number
of published references were presented that
confirmed and supported the guided injections.

Kim G. Gauntt, DPM, Newberg, OR

There are no more messages in this thread.