ultrasound Archives - DOC

#861 Chronic stress reaction versus acute on chronic stress reaction in a runner

I just had a consultation with a runner who had foot pain that she thought might be a stress fracture that had been coming and going for about a month.

She had been increasing her training volume and doing strength exercises that are supposed to build her running fitness.

The pain seemed to be volume related. The more training she did, the more she would notice the discomfort in her foot.

But when we x-rays of her foot, the radiologist suggested this could be an “acute on chronic” stress reaction.

What does that mean?

What is the difference between a chronic stress reaction, or an acute on chronic stress reaction in a runner?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#845 What is hyperemia in medical imaging of shin splints?

I recently saw an elite runner who had what he thought was shin splints. One of the findings on the MRI report was something called “hyperemia.”

He asked me:

“What does that mean? Does that mean I have a stress fracture? Does that mean I have shin splints?”

What does hyperemia mean when you see it on an MRI report or an ultrasound report and you have something like shin splints or a tibial stress reaction?

Well, good question and that’s what we’re talking about today on the Doc On The Run Podcast.

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#815 3 ways to tell if a fracture non-union is stable without imaging

This episode comes from a discussion I called with a runner who called me for a second opinion. She had a stress fracture non-union and somebody had remained recommended that she have surgery.

I was looking at her CT scan and she asked me an interesting question.

She said,

“Does it look stable?”

And I said, “Can’t tell.”

It looks like a non-union. It looks like it’s broken and never healed.

What are the three ways you could tell whether or not a metatarsal fracture non-union is stable without getting an imaging study?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#790 How much earlier than X-ray can ultrasound prove fracture healing?

If you get a fracture of one of the metatarsal bones in your foot, you are not going to be able to run until it heals.

But as soon as it’s healed, you will want to start running again.

You may have recently seen the episode that I did where I was talking about how ultrasound may show signs of healing sooner than X-rays.

How much earlier can ultrasound show healing of a fracture as compared to X-ray?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#764 Fast & Easy vs. Fast & Cheap fracture imaging

I was just speaking with a runner who scheduled a second opinion consultation. He asked, “what is the best way to tell if my foot is broken.”

I said, “Well, there’s the fast and easy way and then there’s the fast and cheap way.”

Today on the Doc On The Run Podcast, we’re talking about fast and easy versus fast and cheap ways to tell if your foot is broken.

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#755 Can MRI miss a plantar plate strain?

Plantar plate injuries are very common, and they are extremely annoying.

I get lots of questions and comments both from the podcast and from the Doc On The Run YouTube channel about plantar plate sprains.

Today’s episode comes from a question posted by Jason on the Doc On The Run YouTube channel. He asked…

“Can MRI miss a plantar plate strain?”

The short answer is yes, and I’m going to try to explain why.

Can an MRI miss a plantar plate strain?

Well, that’s a great question and that’s what we’re talking about today on the Doc On The Run Podcast.

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#728 6 Stages of fracture healing in runners explained

Every runner with a stress fracture wants to know “when can I run?”

How soon you can start running after a foot fracture really depends on when you have enough strength in the bone so that the healing fracture will withstand the forces applied during running without breaking the bone again.

It all depends on what you do to speed up (or slow down) the bone healing process. The rate of fracture healing depends on your physiology, and it depends on stages of bone healing.

But it does NOT depend entirely on generic timelines.

How long is each stage of fracture healing when you have a broken bone?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#636 Plantar Plate Imaging: MRI vs. Ultrasound

Every time a runner calls me who has a plantar plate sprain, they’re trying to figure out how they can know for sure they actually do have a plantar plate sprain. They often also want to know how bad the plantar plate injury really is.

When you’re a runner, the problem with plantar plate sprains is that many doctors will offer a standardized cookie cutter approach.

I most often help runners get better without surgery.

That’s not because I’m a better doctor. It is because I really put a lot of attention into educating injured runners about how to do all of the additional things to get the injury to heal quickly…so that they can skip the surgery.

One way to start healing faster is by imaging the plantar plate to determine the extent of tissue injury.

Plantar plate imaging, MRI vs. Ultrasound.

That’s what we’re talking about today on the Doc On The Run Podcast.

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#473 Heel neuritis doctor did alcohol injection with ultrasound is it a scam?

This episode actually comes from a question I got during the live question and answer period at the end of a talk I was giving at the International Foot and Ankle Foundation meeting in Hawaii.

The question was about one of the conditions that can often be misdiagnosed as plantar fasciitis, and that’s a condition called medial calcaneal neuritis.
With this condition a nerve on the inside of the heel becomes inflamed and painful.
In short, the patient had alcohol injection under ultrasound guidance by another doctor, but the condition dod not get any better.
The question from the doctor in the audience was basically asking me what my opinion about that procedure using ultrasound.

Today on the Doc On The Run Podcast, we’re talking about heel neuritis in a situation where a doctor did an alcohol injection with ultrasound and another doctor wanted to know if that was a scam.

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#472 MRI vs Ultrasound which is better for Plantar Fasciosis or Partial Rupture

A doctor at a medical conference asked me a great question!

I was giving a lecture at the International Foot and Ankle Foundation meeting in Hawaii on runners heel pain, specifically about the, what we call the differential diagnosis or the things that can cause runners heel pain.

In that talk I was also teaching about the differences in treatments between runners like us, and non-runner patients with heel pain.

At the end of that lecture a doctor wanted to know which kind of imaging study was better for a runner with a suspected small tear in the plantar fascia ligament.

Today on the Doc on the Run Podcast, we’re talking about MRI vs Ultrasound. Which is better for Plantar Fasciosis or Partial Rupture in a runner?

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