Extinct-ing the Stone Age (Blind) Practice with Ultrasound

Dear Editor, From landmark-based/palpation-guided ranging from the head to the toe, a wide range of injections have been administered without ultrasonographic guidance in musculoskeletal practice.[1] With time and the renaissance of personalized/safety medicine, musculoskeletal physicians started to elevate their practice with ultrasound (US) imaging. It has been recognized that procedures could be done more safely/precisely under US guidance.[1,2] Although resistance and attitudes of the past still exist, the results of pertinent literature reveal numerous comparative palpation-guided versus US-guided intervention studies as regards the treatment outcome, there is no discussion on the superior school of practice.[3] From our daily clinical practice, we notice the comparison of these two techniques and the significant contribution of US guidance. Before the diagnosis, US imaging gives a difference in the mind of a physician. Although substantial medical history and physical examination might suffice in many cases, in some others, they can be quite inconclusive. Next at the decision-making step, the US guidance provides a more comfortable intervention and decision-making process in interventional technique.[4] Not restricted to a fixed landmark that is described for palpation-guided injections, herewith the insertion may be practical at any region if the target is visualized and reached. Undoubtedly, this is with the comfort of not worrying about local anatomy variations or the relevant pathology’s localization. In addition, either for convenient follow-up after the treatment/procedure or to provide easy/prompt navigation, US imaging, and guidance would be of definite great value. Herewith, the latest literature even reports the use of intraoperative US in some surgeries, and with artificial intelligence-based real-time guidance tools [Figure 1].[5]Figure 1: A snapshot from daily clinical practice in the past and presentIn short, we advocate for early training for the new generation of musculoskeletal physicians and look forward for an ultrasonographic future for the new generations, to extinct the stone age/prehistorical time of palpation-guided practice. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.