Spotlight On Jamie Bie, MSK Ultrasound Technologist

Jamie Bie, RDMS, RVT, RMSK, is passionate about musculoskeletal (MSK) ultrasound—an emerging field of imaging that is used to look at muscles, tendons, ligaments, nerves, and joints. MSK ultrasound is used in the diagnosis of sports injuries and chronic pain, and it's also used to guide pain management treatments such as corticosteroid injections, aspirations of joint fluid or cysts, or platelet rich plasma injections.

Jamie has been the MSK ultrasound technologist at our midtown location for three years. Her love of the modality extends beyond the office, where she runs Learn MSK Sono, a company which provides education for healthcare professionals in need of hands-on MSK ultrasound training. Jamie is also the author of Musculoskeletal Ultrasound: A Comprehensive Guide to MSK Imaging and Interventional Techniques.

Communication with her patients is key to her approach, because it can lead to information that helps inform the exam while it’s happening.

What's unique about MSK ultrasound?

With MSK ultrasound, we look at different structures that just weren't looked at before on ultrasound. It involves no radiation, it's cost effective, it's comfortable for the patient, and we can do dynamic imaging—meaning that we can perform real-time stress of a ligament or tendon to see the extent of an injury, or check for dislocation or subluxation of one structure relative to another.

It's not taught in schools yet so it's a unique skill set that only a limited number of people have and can offer. There are only a few places in NYC that offer it.

What kind of training did you have to undergo to specialize in MSK ultrasound?

I was mentored by a physician who did a fellowship in musculoskeletal ultrasound. He basically took me under his wing for five years, because he needed a technologist so that he could be a radiologist and not be scanning all the time. So I got fellowship training without having to do a fellowship. And I was highly motivated, so I took the ARDMS Pioneer Registry for musculoskeletal ultrasound when it came out.

What's your approach to a patient who comes for a MSK ultrasound?

Ultrasound is very comfortable, and patients are usually pleasantly surprised that they can keep a conversation going with me. The room's dark, it's quiet, and they're lying down and resting. It's not usually a life or death problem. The patients may be young and athletic, or they may have chronic pain, but they generally aren't scared.

They can tell me at the bedside, "This is where it hurts," and I can just look right there. I can really fine-tune the exam while they describe their symptoms to me.

At the end of the day, I want to find out what's hurting them, what's causing them pain. So sometimes I'll go above and beyond to figure that out and not keep myself boxed into what the referring physician wrote. I can use my judgement and the patient's input and be involved in getting the right diagnosis.

What's the most common question you get from your patients?

If we're talking about ultrasound-guided injections, patients are typically afraid of needles and their question is, "Will it hurt?" Usually, they are pleasantly surprised that all they feel is the numbing medicine.

I don't like to tell them that it won't hurt because everyone has a different tolerance for pain. I usually tell them that there's an initial stick and burning from the lidocaine, and then after that they should just feel pressure. If I find inflammation when I'm scanning, I might give them a heads up and say, "It looks a little inflamed so it might be sensitive when we first put the needle in." I think it's better to expect that it might hurt and be pleasantly surprised if it doesn't.

What is it about MSK ultrasound that you love so much?

I love that there's so much variety within the specialty. I think the types of injuries are interesting. And I like that I can be really involved in the decision about what we're going to scan. 

It's new and exciting and not a lot of people know how to do it, so it's something that I'm proud of. I get excited about being able to share it with others, convincing people that ultrasound can be used for these things because it never was before. I like to make them believers!

How do you share all this expertise with others?

I wrote a textbook about it, because I felt that once you write about something, you can never really forget it. My book is basically what I wish I had when I was learning, with step by step instructions: how to hold the transducer, what the image should look like, how you should label it—all the scanning tips that I couldn't find when I was trying to learn. I specifically geared it to ultrasound techs but I've had many physicians tell me that they use it.