ULTRASOUND MACHINES

Ultrasound-guided pain management procedures are becoming more accurate and more popular as reimbursement for c-arm guided pain procedures drops. Reimbursement for ultrasound-guided pain procedures is not as high as most pain management physicians would like, but the ultrasound machines’ ease of use, comparatively low upfront investment, and elimination of exposure to dangerous ionizing radiation are making ultrasound-guided pain management injections a more popular image-guided pain management procedure every day. (Percutaneous Ultrasound-Guided Injections in the Musculoskeletal System)

Normally, the biggest determining factor in the choice of an ultrasound machine for pain management physicians is how much will ultrasound system cost and a close second factor is the quality of the ultrasound image. There are other factors to be considered as well like reliability, ease of use, training on the ultrasound machine, length, comprehensiveness of the warranty, availability of a loaner ultrasound machine during any repair, et cetera.

New ultrasound systems can cost as much as $80,000 or more. I have not been able to calculate an ROI for any pain practice where this even begins to make sense. There are a large number of units in the $20,000-to-$45,000 range that produce fantastic images, but again, any calculation resulting in a desirable ROI (return-on-investment) is virtually impossible. So that leaves ultrasound systems that cost $22,000 and below. Here are a few more popular pain management ultrasound systems in that price range:

• SONON 300L Wireless – $ 2000-3,500*
• Sonosite Mturbo – $8,995*
• GE Venue 40 – $9,800*
• GE Logic-e – $13,750*
• Sigma P5 – New – $14,900*
  *Prices on ultrasound systems are currently fluctuating greatly due to product shortages and long delivery times.
  Click here for pictures and information on the ultrasound systems above

Up until the last year-and-a-half, the most popular price range for ultrasound systems being used for pain management injections was $12,000 to $15,000, with a significant percentage of those being in the $8,000-to-$12,000 price range. The systems in this price range produce a good-to-better-than-average image for most pain management doctors with the biggest variable being the level of expectation of image quality by the doctor.

Physicians just leaving positions where a $45,000 GE ultrasound system or Mindray system might expect a little more in terms of ultrasound image quality than what these lower-cost ultrasound systems can produce, but overall most pain management physicians would be more than satisfied with the image quality.

Over the last decade, ultrasound systems for pain management practices have gone from large console-based machines about the size of an apartment refrigerator down to desktop-based machines and then down to laptop-sized ultrasound machines. Today where there are several ultrasound machines that are hand-held and wireless small enough that you can carry them in your pocket.

The cost of the wireless handheld ultrasound can be as low as $3,000 to $6,500. Many of these wireless transducers can connect to your iPhone, iPad, or Android phone or tablet. The more expensive of these wireless ultrasound transducers have better images, longer warranties, longer battery life, better balance, better ergonomics, and lower weight which can affect the price significantly.

One of the major disadvantages of handheld wireless ultrasound machines is the fact they are normally either a linear transducer or a curved transducer. There is one that has different transducer types on each end. This means you need to either buy two versions of the ultrasound machines or restrict yourself to using them only with shallow injections or deep injections instead of both. Hmmm, probably not something most doctors would accept. I have several pain management physicians who just use one of the better wireless linear probes for most pain procedures and do their hip injections with a c-arm.

Over the last few months, several significant technological innovations have been demonstrated at larger medical imaging conferences across the world. The largest medical imaging conference is the RSNA in Chicago at the end of November. I fully expect these changes to result in better and better wireless ultrasound systems being sold by ultrasound manufacturers in the very near future. There are some manufacturers that will give you a limited guarantee, that if you buy now they will upgrade you to the newer, more advanced ultrasound machines when they come out. If you decide to go this way, make sure you read the contract carefully. Some of the promises are not what they make them out to be.

So, back to the question “What is the most popular ultrasound machine for pain management procedures? It is a pretty even split between the SONOSITE laptop-based systems like the SONOSITE m-TURBO, one of the GE Logiq e ultrasound systems, or one of the GE Venue ultrasound machines.