VISITING LECTURER SERIES
Orthopaedic Surgery Academic Conference
Wednesday March 25, 2009 7:00 – 11:00 a.m.
Kresge Eye Institute Auditorium 4717 St. Antoine, Detroit
The Use of Diagnostic Ultrasound in Sports
The high-resolution imaging, hand-held portability and dynamic stress scanning of MusculoSkeletal
Ultrasonography (MSUS) is a welcome addition for the sports orthopod in the diagnosis of athletic
injuries. Soft tissue trauma, joint abnormalities and cortical surface defects are readily visualized by this
technology. Partial- or full-thickness tears and strains of tendons and ligaments can documented.
Without the use of IV contrast, attendant synovitis in even minimally effusive joints or bursas can be
depicted. Muscle defects can be evaluated with longitudinal studies to confirm normalization, involution
of the lesions or detect residual complications. Radiographically-occult fractures or sub-millimeter
cortical avulsions, along with subperiosteal hematoma can be differentiated. Stress maneuvers can
confirm abnormal translation and measure asymmetric distractions in osteoarticular structures, with rightleft limb comparisons. MSUS is readily accessible to the injured sportsman, without scheduling hassles,
and affords immediate diagnosis in the dressing room or sidelines. MSUS is a helpful tool in many
Sports Clinics and athletic events, and can be performed by all doctors, athletic trainers and, possibly,
physician-extenders.
Ultrasonography of the Shoulder
Shoulder ultrasonography is the most frequently requested MSUS study in our institution. This modality
is commonly employed as the screening tool for the painful shoulder. The high-resolution and real-time
imaging gives accurate diagnosis (94 to 97 percent, in several institutions) of rotator cuff tears. The
dynamic stress views help in the confirmation of the structural defects responsible for the patients’
symptoms. Effusions and synovitis of the SASD bursa and joints are readily detected, and without the
need for IV contrast. Ultrasound-guided intervention procedures are being steadily introduced for fluid
aspirations, biopsies, injections and percutaneous removal of calcifications. With optimal acoustic
windows, parts of the glenoid labrum can be visualized. The tomographic nature of MSUS is very
sensitive to incipient cortical irregularities or radiographic-occult fractures. MSUS is been helpful in the
post-operative shoulder. In shoulder imaging and management, MSUS should be an essential
armamentarium. This technology is taught to and used by many physicians and allied health experts in
Sports Medicine who attend to shoulder pathology.
Presented by J. Antonio Bouffard, M.D.
Dr. Bouffard is currently a Senior Staff Radiologist in the
Division of Musculoskeletal Imaging at Henry Ford Hospital,
which performs all modalities, including MRI, Ultrasound and
Interventional Radiology.
Dr.Bouffard earned both his Bachelor Degrees of Science, and
Education, at the University of Toronto. He studied medicine at
the Manila Central University, Philippines. He then went into his
Radiology Residency at the Detroit Medical Center, Wayne State
University. Dr.Bouffard completed his Fellowships in Nuclear
Medicine and Magnetic Resonance Imaging at the University of
Michigan Medical Center.
DMC Sports Medicine Visiting Lecturer:
J. Antonio Bouffard, M.D.
Tony was born in the Philippine Islands, and raised in Barcelona (Spain), Manila
(Philippines) and Toronto (Canada). He finished both his Bachelor Degrees of Science,
and Education, at the University of Toronto. He studied medicine at the Manila Central
University, Philippines, in 1980. After an Internship at KUMC (University of Kansas
Medical Center), he worked as a Family Physician in Smith Center, Kansas. He then
went into his Radiology Residency at the Detroit Medical Center, Wayne State
University. In 1988, he completed his Fellowships in Nuclear Medicine and Magnetic
Resonance Imaging at the University of Michigan Medical Center.
He worked at the Holy Cross Hospital, in Detroit, before joining Henry Ford Hospital.
Prior to becoming a full-time Bone Radiologist, Tony was Director of HFH Northeast
satellites, which included the Sterling Heights and Lakeside Clinics. He is currently a
Senior Staff Radiologist in the Division of Musculoskeletal Imaging, which performs all
modalities, including MRI, Ultrasound and Interventional Radiology. Henry Ford Hospital
is a Teaching Hospital with 50 Radiology Residents and 4 Bone Radiology Fellows.
Tony has published several book chapters and articles in many peer-review journals in
both the English and Spanish-speaking world. He has been invited to give over 500
lectures in local, regional, national and international meetings. He has lectured in 32
different countries. Currently, he has appointments as Consultant Radiologist to NASA,
the United States Olympic Committee and to the James Andrews Orthopedics and
Sports Medicine Center.
DMC SPORTS MEDICINE
Mission:
The Detroit Medical Center Sports Medicine Program is dedicated to a multiplespecialty, multifaceted approach to the treatment and prevention of sports-related
injuries. We work with and educate athletes of every age and level, and their
communities, in leading healthy, active injury-free lives. In the face of lifestyle-changing
issues or injuries, we strive to return every individual to abilities at or above pre-injury
levels.
Objectives:
The DMC Sports Medicine Program accomplishes our mission through:
 Excellent clinical care
 Basic science and clinical research
 Caring for amateur and professional teams
 Resident, fellow and allied health professional education
 Community outreach and education
The Wayne State University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide
continuing medical education for physicians. The Wayne State University School of Medicine designates this educational activity (CME
#2008441319) for a maximum of 4 AMA PRA Category I CreditTM. Physicians should only claim credit commensurate with the extent of their
participation in the activity.