The sports medicine specialists at NYDNRehab are experts in diagnostic musculoskeletal ultrasonography. Diagnostic Ultrasound not only enables the doctor to identify the structural causes of knee pain, but it allows your clinician to view the knee region in real time, with the knee in motion. In addition to ultrasound, video gait analysis can help us identify faulty movement mechanics that contribute to hip and groin pain. Once the exact cause is determined, an effective treatment plan can be initiated.
In conjunction with clinical exam, diagnostic ultrasound can provide an accurate diagnosis of ITBS, while ruling out other causes of pain such as bursitis or tendinopathy.
Computerized gait analysis can provide useful information about faulty gait mechanics that lead to ITBS, which is the primary cause of the condition in runners.
Please explore more advanced diagnostic option unavailable anywhere else:
Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.
The stinging feeling that is felt above the knee joint on the outside of the knee. At times the pain may strengthen over time and may not be felt in the beginning or during activity. In some instances the IT band pain may be felt above or below the knee, where it attaches to the tibia.
While the causes of ITBS may vary on a person by person basis and at times more than one cause may be a factor in falling victim to Iliotibial band pain. Some causes may be a combination of biomechanical tissue, weekly mileage, training methods, personal muscle imbalance etc… Keep in mind that you do not to have a knee specific knee injury to have ITB syndrome.
Tissue injury complex must be identified. A diagnostic ultrasound may be the most useful modality to differentiate between tendinopathy or bursitis at the site of injury.
By addressing these two factors it is important to minimize stress of the ITB and in turn it will reduce the risk of injury.
Tissue injury complex must be identified. A diagnostic ultrasound may be the most useful modality to differentiate between tendinopathy or bursitis at the site of injury.
When IT band syndrome is acute therapy options could be rest, ice, and elevation. to minimize and reduce the swelling and pain combined with stretching. ITBS treatment could be a combination of several ITB physical therapy modalities that will result in a wider range of motion and improved comfort and reduced pain. Iliotibial band treatment should include removal of adhesions with myofascial release techniques such as ART, graston and others, custom foot orthotics which would control the medial rotation of the foot and in turn reduce the rotation of the knee and leg. Too much rotation of the knee creates friction of the band against the other part of the knee. A compression wrap can also be utilized to help stabilize the knee where the tendon contacts to the patella. Multiplanar muscle stretching and hip abductor strengthening. Gait and running analysis is very helpful in diagnosis and planning of rehabilitation as well as running technique retraining.
and a faulty diagnosis can make treatment a total waste of time.
Failure to accurately diagnose a condition in its early stages can lead
to chronic problems and sometimes devastating results.
Diagnostic musculoskeletal sonography (MSUS) provides the perfect tool for the rehab practitioner. Yet many doctors and physical therapists have no experience with MSUS, are unaware of its advantages, and have no idea how to use it as a diagnostic tool.
Below is a prime example of how ultrasound can take the guesswork out of diagnosis.Successful Treatment
A bad physical therapy experience is one of the primary causes of unnecessary surgery.
We have equipped our clinic with the latest research-grade technology to arrive at objective and accurate diagnoses, and to objectively measure our patients’ progress.
Most importantly, we are the only facility in the US where structural medical diagnosis is reflected in functional treatment, and vice versa.
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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