Five emerging clinical technologies you NEED to know about

The world is moving fast, and here at Bartold Biomechanics, we are committed to making sure you know EXACTLY what is going on.

Here are 5 technologies that only a few years ago would have been considered experimental, but in 2018, they are now considered mainstream, and you will be exposed to these techniques in your clinical practices.

1. Supersonic shear wave elastography 

Is a novel ultrasound technology that allows non-invasive and quantitative evaluation of soft tissue stiffness ( Bercoff et al. 2004 ). It has been extensively applied to evaluate the stiffness of various tissues for providing better basic understanding and clinical diagnosis, such as characterization of liver fibrosis ( Ferraioli et al. 2014; Samir et al. 2014 ), breast masses ( Chang et al. 2013; Lee et al. 2013 ), prostate cancer lesions ( Boehm et al. 2015 ), thyroid nodules ( Liu et al. 2015 ) and musculoskeletal soft tissues including muscles and tendons ( Chen et al. 2013; DeWall et al. 2014; Hatta et al. 2015; Koo et al. 2014 )

An interesting recent study used SWE to investigate the stiffness of the plantar heel pad in the weight-bearing condition. The motivation of this study was to investigate the difference in the heel pad stiffness in the weight-bearing condition between plantar heel pain patients and normals in order to understand whether plantar heel pain was associated with a change in the heel pad stiffness in the weight-bearing condition. 

ultrasound heel.jpg

(a) The experimental setup for measuring the stiffness of the plantar heel pad in the weight-bearing condition.
(b) Some strange stiffness regions (marked by arrows) were observed on the color elasticity map.
The stiffness values of these regions were significantly lower than those of adjacent regions

2. Finite element modelling

Over the last two decades finite element modelling has been widely used to give new insight on foot and footwear biomechanics. However its actual contribution for the improvement of the therapeutic outcome of different pathological conditions of the foot, such as the diabetic foot, remains relatively limited. This is mainly because finite element modelling has only been used within the research domain. Clinically applicable finite element modelling can open the way for novel diagnostic techniques and novel methods for treatment planning/optimisation which would significantly enhance clinical practice.

Simon Bartold
Director of Bartold Clinical