Medicine
Medical ultrasound "Ultrasound Therapy (medicine)") is an ultrasound-based medical imaging technique used to visualize muscles, tendons and many internal organs to capture their size, structure and any pathological lesions with real-time tomographic images. As currently applied in the medical field, properly performed ultrasound poses no known risks to the patient. Ultrasound does not use ionizing radiation, and the power levels used for imaging are too low to cause adverse heating or pressure effects on tissues.[14].
It is very simple for the GP to determine, for example, when a patient requires urgent surgery and when he or she does not require it. Likewise, it simplifies the diagnosis quickly and rules out possible defects in softer tissues.
Ultrasounds have been used by radiologists and sonographers to image the human body for at least 50 years and have become a widely used diagnostic tool. The technology is relatively cheap and portable, especially when compared to other techniques, such as magnetic resonance imaging (MRI) and computed tomography (CT).
Ultrasound is also increasingly used in trauma and first aid cases, with emergency ultrasound becoming a staple of most EMT response teams. Additionally, ultrasound is used in remote diagnostic cases where teleconsultation is required, such as scientific experiments in space or diagnosis of mobile sports equipment.
It is also used to visualize fetuses during routine prenatal and emergency care. These diagnostic applications used during pregnancy are called obstetric ultrasound, which we will see below.
Although the long-term effects of ultrasound exposure at diagnostic intensity are still unknown, most physicians currently consider the benefits to patients to outweigh the risks. The ALARA principle (as low as reasonably achievable) is recommended for ultrasound examinations, in order to keep scan time and power settings as low as possible but consistent with diagnostic imaging in non-medical uses.[15].
As an improvement, Doppler ultrasound is based on the effect of the same name. When the object reflecting the ultrasound waves moves, the frequency of the echoes changes, increasing in frequency if it moves toward the probe and decreasing in frequency if it moves away from the probe. How much the frequency changes depends on how fast the object is moving. Doppler ultrasound measures the change in the frequency of echoes to estimate how fast an object is moving. It is primarily used to measure the speed of blood flow through the heart and major arteries. We will see below its application in cardiology, mainly.
This diagnostic technique is also known as ultrasound or sonography.[16].
The ultrasound machine has piezoelectric crystals that, when stimulated by electricity, vibrate, producing high-frequency sound waves that echo in the body structures, returning to the crystals that, now stimulated again by ultrasound, produce small voltages that are processed according to their intensity and return time by a computer that has a digital scanning converter, thus creating the images. Unlike X-rays, this examination does not involve any exposure to ionizing radiation and no risk has been detected when used with appropriate diagnostic devices. Currently there are ultrasound machines the size of a cell phone that can be used for immediate diagnosis.[17].
Typical frequencies used for applications in the abdomen can range from 2.0 MHz to 5.0 MHz while for regions such as breast, musculoskeletal, thyroid, etc., frequencies can range between 8.0 MHz to 16.0 MHz. Higher frequencies are used for measurement of very small and superficial structures.
At intensities and application times much higher than those used in ultrasound diagnosis, cavitation (bubble formation) and an increase in temperature have been detected, as well as sonoluminescence, which is the emission of light through ultrasound stimulation.
Doppler is a variety of traditional ultrasound, its most useful use being visualization of fluid flow within the body. In addition, the color representation is used to determine the direction and speed of the liquid flow. Doppler is now used very little in obstetrics because its power is much higher and can produce adverse effects on the fetus.
Echocardiography is located within this area, which also allows obtaining a presentation in the form of a range of colors according to the speed of a fluid, such as blood. This technique has special impact on:
• - Dilation of parts of the heart and function of ventricles and heart valves.
• - Transthoracic echocardiogram: In this case, the echocardiography transducer (or probe) is placed on the subject's chest wall (or thorax), and images are taken through the chest wall.
• - Transesophageal echocardiogram: A probe ending in a transducer is passed through the patient's esophagus. This allows evaluation of an image directly behind the heart. They are most commonly used when transthoracic images are of poor quality.
It measures the amount of fluid retained in the patient's bladder.
Pelvic sonograms show the organs of the pelvic region: uterus, ovaries, urinary bladder, prostate and testicles.
There are two methods to perform a pelvic ultrasound: external or internal. Internal pelvic ultrasound is performed transvaginally (in a woman) or transrectal (in a man).
Tendons, muscles, nerves, ligaments, soft tissue masses and bone surfaces. It is an alternative to radiography in the detection of wrist, elbow and shoulder fractures for patients up to 12 years of age.
Most structures in the neck, including the thyroid and parathyroid glands, lymph nodes, and salivary glands, are well visualized by high-frequency ultrasound with high-quality images. Ultrasound is an imaging modality with special incidence in thyroid lesions.[19].
Many other benign and malignant conditions in the head and neck can be evaluated and managed with the help of diagnostic ultrasound and ultrasound-guided procedures.
In abdominal ultrasound, images are formed of the solid organs of the abdomen such as the pancreas, aorta, inferior vena cava, liver, gallbladder, bile ducts, kidneys, and spleen. Sound waves are blocked by gas in the intestine and attenuated in different degrees of fat, so there are limited diagnostic capabilities in this area. The appendix can sometimes be seen when it becomes inflamed.[20].
Therapy
In physical therapy it has been used since the 1940s especially to reduce pain or improve inflammation in deep muscles, treat connective tissue: ligaments, tendons and fascia (and also scar tissue).[23] Specifically, therapists use this technique to treat ligament sprains, muscle strains, tendinitis, joint inflammation, plantar fasciitis, metatarsalgia, facet irritation, impingement syndrome, bursitis, rheumatoid arthritis, osteoarthritis and scar tissue adhesion.
It is used with more powerful intensities and high frequencies, around 1-3 MHz. There are a large number of doctors who distrust the program and do not recommend it to their patients.[24] There are not a large number of studies carried out in this regard, and the design of those that exist does not allow confirming or denying the effectiveness in the treatment of pathologies of the musculoskeletal system; It is therefore necessary to continue studying.[25].
Its use is analgesic, regenerative, anti-inflammatory, and its rebound wave travels up to 100% of the bone. We must be very careful in the application of this medium, due to the complications that it entails, with greater concern in women and children, which, like all physical agents in rehabilitation, can produce mutations in the cells of the human body (altering the cells and even altering some types of tumors), which is why this type of equipment should be used exclusively by highly trained professionals, to avoid all the complications that it entails. both to patients and to those who apply it.
Another example of its use in medicine is extracorporeal shock wave lithotripsy, a therapeutic technique for the treatment of kidney stones.