Dr Iain Duncan
shoulder pain

Recommendations for Management of Rotator Cuff Tears

There are extensive recommendations from the American Academy of Orthopaedic Surgeons about Management of Rotator Cuff Injuries Clinical Practice Guidelines, Published in March 2019. Some strong and moderate recommendations are listed below. Weaker recommendations have not been listed. STRONG = Evidence from two or more “High” quality studies with consistent findings for recommending for or […]

knee pain

Efficacy and Treatment Response of Intra-Articular Corticosteroid Injections in Patients With Symptomatic Knee Osteoarthritis

keywords: knee osteoarthritis, corticosteroid injections, osteoarthritis, injection therapy Authors: Elizabeth G. Matzkin, MD; Emily J. Curry, BA; Qingwu Kong, MD; Miranda J. Rogers, MD; Michael Henry, MD; Eric L. Smith, MD   (c) J Am Acad Orthop Surg. 2017;25(10):703-714.    Introduction: Intra-articular corticosteroid injections are often used for short-term pain relief in patients with knee osteoarthritis (OA). This […]

Tendinopathy

WHAT IS TENDINOPATHY?

Tendinopathy is a term used for painful conditions occurring in and around tendons in response to injury and/or overuse and ageing. The natural course of symptoms is variable but most ultimately resolve (even if the tendon appearance on scans does not). Generally the length of symptoms varies according to age and severity.  A recent study suggested the median length of symptoms was 14 months. The incidence of symptoms in sedentary people is highest in middle age though at particular sites (lateral hips and shoulders) the incidence is greater with increasing age.

Achilles tendon swelling with micro-vascular change

HOW IS IT DIAGNOSED?

Ultrasound can confirm or rule out the diagnosis but the presence of tendinopathy on ultrasound does not necessarily indicate whether it is the cause of your symptoms.  The relationship between symptoms and the scan findings is determined by a clinician who combines the clinical history, examination findings, and all test and scan results. The incidence of asymptomatic tendinopathy also increases with age (i.e. many patients have scan findings of tendinopathy but no real symptoms).

A (well performed) ultrasound or MRI scan will determine whether there are significant tendon tears, inflammation, bursitis, or other nearby soft tissue pathology. It can broadly categorise the type of tendinopathy which usually helps in determining treatment options.

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Services Available

Iain primarily practices within the framework of medical imaging in Canberra, by supervising and reporting quality ultrasound and nuclear medicine.  His team can provide all the services that cover the entire spectrum of ultrasound and nuclear medicine. Nuclear Medicine Services Available see also nuclear medicine for dummies  BONE SCANS REGIONAL MULTIPHASE BONE SCANS WHOLE BODY […]

Corticosteroid Injections

CORTICOSTEROID INJECTIONS FREQUENTLY ASKED QUESTIONS Iain has also co-authored a comprehensive corticosteroid injection consumer guide with additional information for health professionals  in Inside Radiology a project of The Royal Australian and New Zealand College of Radiologists.  Here are the links to the Inside Radiology guide to  Bursal Injections and Carpal Tunnel Injections.   WHY HAVE I BEEN […]