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Ultrasound Clinical Solutions
Cadwell is dedicated to proactively advancing the technology of Neuromuscular Ultrasound and delivering education regarding its use. We believe that by providing a fully integrated EMG/US diagnostic solution, and by driving the development of dedicated ultrasound-focused features, we are helping you help others.
Electrodiagnostic testing has a new comprehensive clinical approach, combining clinical, NCS, and EMG studies with neuromuscular ultrasound
Neuromuscular Ultrasound (NMUS) is an emerging diagnostic subspecialty recognized as a complementary practice for neurodiagnostic testing in neurology and physical medicine and rehabilitation (PM&R).
Often used in conjunction with Electromyography (EMG), Nerve Conduction Studies (NCS), and needle procedures, high-resolution neuromuscular ultrasound helps provide real-time anatomic and physiologic information to:
- Study peripheral nerves
- Sensitively observe muscle disease
- Enhance nerve localization
- Guide appropriate intervention or prevent unnecessary intervention
- Provide crucial anatomical information for planning therapies and surgeries
- Guide local anesthetic administration for nerve blocks
- Improve safety margins for injection needle procedures, EMG needle placement, and direct needle stimulation of deep nerves
CPT Codes for Ultrasound
CPT Code updates reflect the clinical benefit of integrating NMUS into a clinical test.
Integrate NMUS into your EDX workflow
Cadwell was the first—and remains the only—electrodiagnostic (EDX) solution provider to integrate neuromuscular ultrasound into its EDX solution. The next-generation Sierra NMUS1 Ultrasound provides high-resolution neuromuscular ultrasound within the Sierra software platform, with seamless workflow and integrated controls on the Sierra Summit Base Unit.
Sierra Summit combined with Sierra NMUS1 Ultrasound is a powerful, comprehensive tool that can enhance the clinical approach you take with patients with peripheral neuropathies.
Cadwell Whitepaper: The Case for Neuromuscular Ultrasound
Recent developments in high-frequency ultrasound imaging technology have resulted in neuromuscular ultrasound (NMUS) becoming another important component of neurodiagnostic evaluations. Ultrasound can help diagnose common entrapment neuropathies and localize other nerve problems. Combined with EMG or NCS, you can increase your diagnostic certainty quickly, safely, and without patient discomfort.
Use Sierra NMUS1 for musculoskeletal ultrasound
Musculoskeletal ultrasound (MSK US) is a dynamic diagnostic tool for assessing soft tissue, muscles, cartilage, ligaments, and joints. MSK US dynamically visualizes passive and active movement to help evaluate slide, rotation, tension, clicking, mobility range, and tissue/bone conflicts.
Sierra NMUS1 Ultrasound now provides the high resolution needed to assess tissue’s echogenicity, structure, borders, nature, size, behavior, and the ratio of and proximity to other structures, especially vessels and nerves.
MSK US with Sierra NMUS1 can help assess:
- Targeted compression
- Vascular supply
- Resilience or elasticity of fluid reservoirs or tissues, i.e. scar maturity
- Inflammation
- Metabolic activity
Real-time MSK US
- Dynamic visualization
- Ability to see moving tissue
- Ability to see vascular flow with Doppler imaging
- Protect target and surrounding soft tissue structures in diagnostic and therapeutic needle guidance procedures
Safe, portable, and cost-effective Sierra NMUS1
- No ionizing radiation
- Can be used with metallic implants
- No claustrophobia, as with other imaging modalities
- No restrictions or known adverse effects
- Instant feedback of results
- Enhance safety and accuracy in needle procedures
Sierra NMUS1 can show:
- Muscle fasciculations and fibrillations
- Atrophy and hypertrophy
- Changes in quantitative muscle echointensity
- Dynamic visualization of moving tissue
- Vascular flow with Doppler imaging
- Structures in diagnostic and therapeutic needle guidance procedures, to protect both the target and surrounding soft tissue structures
- Reference standards
Clinical indications for EMG/NCS + NMUS*
- Carpal tunnel syndrome
- Inflammatory myopathies
- Intraneural ganglion cysts
- Muscular dystrophy
- Nerve and muscle trauma
- Nerve transections and lesions
- Neurogenic muscle atrophies
- Neuromas
- Neuropathies
- Peripheral nerve entrapments and tumors
- Therapeutic injections of botulinum toxin, steroids, and biopsies of nerves and muscles
*Cited from AANEM Position Statement: Neuromuscular Ultrasound Qualifications (2014). Walker, Alter, et al.
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