Professional case studies by Peter Esselbach from Ultrasound Solutions. Each case study deals with a unique situation. 5 complete case studies including images.

Case Study 1

Sean is a 52 year old male who reported pain in his right upper arm following being pulled from the water abruptly while water skiing. He noticed bruising develop in his right cubital fossa and experienced pain with putting his right arm into internal rotation. He also had pain abducting his right arm above 90 degrees. His GP sent him for investigations and treatment, thinking he had a tear to his distal biceps brachii muscle.

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Case Study 2

Mark is a 48 yo who presented with 2 years of intermittent LBP, groin pain and lateral hip pain. He was initially diagnosed with a likely herniated lumbar disc causing his referral pattern of pain into his groin and thigh.

Initial treatment was to take NSAIDʼs, pain medication and have physiotherapy for his lumbar disc complaint. This involved a series of visits for lumbar spine mobilisation, massage and a home exercise program of core stability exercises.

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Case Study 3

Anne is a 70 yo lady with right posterior heel pain and a history of insertional calcific tendinopathy. She had previous treatment to the heel with ultrasound guided cortisone which had no effect and shockwave therapy which after 6 weeks had a 90 % reduction in her pain. She presented 7 months later reporting her pain had returned in the same area.

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Case Study 4

Gavin is a 45 yo male and is a keen hiker. He presented with a 3 year history of increasing heel pain and suspected mid substance Achilles tendinopathy.

He had previous treatment to the heel with physiotherapy which included eccentric calf loading and soft tissue massage to the calf which appeared to only increase his symptoms.

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Case Study 5

Richard is a 48 yo male and is a keen dragon-boat enthusiast. He presented with a 8 month history of slowing increasing L shoulder pain which he experienced when flexing his shoulder above 90 o and abduction above 80 o. He had 3 months of physiotherapy including massage, posture advice and rotator cuff strengthening exercises. Given therapy had failed to improve his symptoms he presented for a diagnostic ultrasound, with the view to have a cortisone injection for pain relief.

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