When compared, Extracorporeal shockwave therapy (ESWT) and radial shockwave therapy (RSWT) have many differences. How they are used is the main difference, the type of energy along with it’s density as well as the depths into the muscle tissue. The end result of the stimulation and the mechanism of these two therapies are similar. ESWT wave speeds are much faster than RSWT wave speeds and ESWT waves break the sound barrier which is different than RSWT which doesn’t have a shock wave at all.
The wave forms are different too, ESWT waves are not long and not less intense like RSWT. The ESWT is more of an acoustic wave with a very high pressured amplitude with short intense pulses while the RSWT is thought to be more of a pressure wave.
RSWT is put right onto the skin itself and waves of pressure are created along skin surfaces. With ESWT shockwaves and force created in these machines is transferred to your skin and tissues without effect, and is focused at a specific desired depth. RSWT is different in that it is applied to your skin and pressure waves are generated by repeatedly bouncing upon your skin with pressure wave devices, creating pressure waves through your body.
When using radial shockwaves, waves disperses through to tissue beneath. ESWT is a better choice of treatment when dealing with deep tissue injuries. RSWT is most effective when treating superficial injuries. You may be required to undergo anesthesia when undergoing Extracorporeal shockwave therapy.
In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.
Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.
The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.
Dynamic ultrasonography examination demonstrating the full thickness tear and already occurring muscle atrophy due to misdiagnosis and not referring the patient to proper diagnostic workup
Demonstration of how very small muscle defect is made and revealed to be a complete tear with muscle contraction under diagnostic sonography (not possible with MRI)
Complete tear of rectus femoris with large hematoma (blood)
Separation of muscle ends due to tear elicited on dynamic sonography examination
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