Best affordable handheld ultrasound for podiatrists

[F8T]

Any experience with low cost handheld ultrasounds? Which do you recommend?

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[Pronation]

We lookin do some ultrasound guided injections to help us find that plantar fascia eh?

 

[F8T]

We lookin do some ultrasound guided injections to help us find that plantar fascia eh?

That is the plan

 

[Feli]

Butterfly is ok... maybe 3k for first year. Thats relatively cheap, and as said above, profit is the only reason for DPM u/s. The u/s inject codes, like sclero codes or prp or amnio or other dpm stuff, are subject to overuse reduction any day, so don't overspend on equip for a billing party that could fizzle out.

Big butterfly downside is it only works with apple app and apple junk devices. So, add a other 1k for iPad, chargers/connects, cart to put it on etc...

It comes in a sleek box that makes it look like a high end adult novelty. That may or may not offset the membership fees. Dunno.

Then you get to pay annual fee on it ('membership'). Oh, and you buy new devices when apple makes a new iOS that needs more memory than a 5 year old iPad has.

 

[dtrack22]

Then you get to pay annual fee on it ('membership').

That used to be only to store images on their cloud. You don’t necessarily need to do that to use the device and store the images

I had one, honestly I found US in general wasn’t worth the hassle. It was more effort and time than any reimbursement was worth. But I was solo. And when I say solo, I mean no MA solo. And even when I did have an MA I was still too lazy to utilize it.

 

[Feli]

That used to be only to store images on their cloud. You don’t necessarily need to do that to use the device and store the images

I had one, honestly I found US in general wasn’t worth the hassle. It was more effort and time than any reimbursement was worth. But I was solo. And when I say solo, I mean no MA solo. And even when I did have an MA I was still too lazy to utilize it.

Yeah, it may have changed. U/s is fine for confirming Achilles ruptures, etc... basically, stuff one can confirm clinically... or is about to get MRI for regardless.

I use u/s occasionally... always tell pt the inject will be more costly but shows a bit more info. I consider it a show that some of them want, most pass to not waste $. I feel that anyone claiming to see neuromas, arterial calcif, stress fx, pero or post tibi, etc well and definitely is FOS. And any DPM who can't inject plantar fascia, first mpj, ankle, etc without its 'guidance' is also definitely FOS.

At the end of the day, podiatry ultrasound is a "practice management" thing, through and through. Nobody would use it if it paid same/similar to regular inject codes. For anything (office handheld) u/s changes the treatment of, it will be advanced imaging anyways. Jmo tho...

 

[Pronation]

Many insurances reject the US add on code stating not medically necessary (shocker), and those that do reimburse it pay very little and for good reason.

 

[Adam Smasher]

I have a butterfly iq. It's a nice clinical adjunct but not much more.

Best indications:
-foreign body removal, especially pediatrics
-needle guidance for lesser TMT injections
-when insurances deny your MRI because you didn't do a US first.

If you're good at US you can use it for perioperative planning certain cases and save pts a MRI. However, biggest downside to a lot of these handhelds is they max out at 10 MHz whereas you need 18 MHz to get the stunning detail you see online.

On the other hand, at their price point, you need a compelling reason not to have one on hand.

 

[heybrother]

Good commentary.

 

[Feli]

So, update: I broke down and bought a Philips Lumify ultrasound (msk one with the 12-4 probe, obviously) for my solo office... was gonna wait until year end for tax reasons, but the new office has been busy and profitable a lot faster than expected and rep gave me a good deal vs sticker price.

I will say the Philips puts Butterfly to SLEEP.... it's not even comparable. The Lumify is a lot clearer and higher quality imaging; it's not even close. It is like Butterfly is a kids' toy while Lumify is a real medical device. Apparently there a few comparison studies with same conclusions of Lumify >>> the rest of POCUS makers for various ER, OB, cardio, etc applications also (I guess the VScan by GE is also pretty good, but I've never used it and not sure how affordable it is). Butterfly recently and another brand Esoate back in pod school (good, but big and expensive) was all I'd used until this month... night and day difference.

The Lumify does cost almost twice as much ($6k retail, can get it for $4k to $5k from big company reps... no fees or subscription afterwards on the Philips), so I'm sure that bigger up-front cost is why Butterfly is still so popular with DPMs. And yeah, they all bill the same, obviously. If you want to just bill for PF or first MPJ injects that don't even need u/s to begin with, it probably doesn't matter.. but for real visual quality (tendons, ligaments, etc), definitely look into the Lumify.