Musculoskeletal ultrasound evolving rapidly
Musculoskeletal ultrasound (MSK US) is a rapidly evolving modality, which is gaining popularity for the evaluation and management of joint and soft tissue disorders.
MSK US is a dynamic, non-invasive exam that allows high-resolution, real-time evaluation of a variety of MSK disorders. MSK US also provides a means of visualization for performing guided needle procedures. Using ultrasound ensures that the injection is accurately placed in the exact pathoanatomic location and helps to reduce the potential for damage to surrounding tissues.
Q.What is musculoskeletal ultrasound?
MSK US uses high frequency sound waves to produce images. It was first described being used to evaluate components of the musculoskeletal system in 1958. Outside the United States, MSK US is often the primary modality performed for many clinical indications. In the last few years, with advances in imaging technology, the use of ultrasound to evaluate normal and abnor- mal musculoskeletal tissues has become increasingly common. The evolu- tion of MSK US has reached a point where it has become possible for clini- cians to have high quality real-time imaging in the office setting.
Q.What can musculoskeletal ultrasound be used to evaluate?
• Tendons
Partial and full-thickness tears
Degeneration
Scar tissue formation
Calcification
• Ligaments
• Muscles
Tears
Hematomas
• Nerves, including the carpal tunnel
• Bones – stress fractures
• Soft-tissues
Masses
Cysts
Detection of foreign bodies
• Joints
Effusions
Loose bodies
• Vasculature – neovessels (small blood vessels in the area of injury which can be a sign of injury and can be followed as healing progresses)
Q. How can musculoskeletal ultrasound guidance be used for treatment?
• Aspiration and/or injection of joints
• Tendon origin injections (i.e. tennis elbow)
• Tendon sheath injections (i.e. trigger finger)
• Bursa injections and aspirations
• Aspiration of cysts, fluid collections and abscesses
• Lavage and aspiration of tendon calcifications
• Foreign body retrieval
• Injection of platelet-rich plasma (PRP)
Q.What are the practical advantages of musculoskeletal ultrasound over other diagnostic and procedure-assisted imaging modalities?
• Less expensive and more cost effective
• Safe
• Real-time capability
• Lack of radiation
• High degree of resolution
• Capability to make quick comparison with the contra-lateral side
• Greater patient acceptance
No claustrophobic tunnel
No loud noises
No awkward positioning
Short exam time
Non-invasive
Painless
• Dynamic imaging (stress and kinetic views)
• Ability to differentiate cystic from solid and vascular from non-vascular lesions
• Safe for patients withpacemakers,metallic implants,and metallic foreign bodies
• Easily accessible
Musculoskeletal ultrasound is a powerful diagnostic and therapeutic tool that can be utilized by sports medicine physicians in the office. It is less expensive than MRI, has no radiation exposure, and can be used to assess musculoskeletal anatomy in motion. Ultrasound can be a quick, readily available and accurate technique for musculoskeletal evaluation, especially for many common joint and tendon injuries.
Orthopaedic Specialists of the Carolinas, P.A. now offers musculoskeletal ultrasound to diagnose a wide variety of orthopaedic and sports-related injuries and other causes of muscle, ligament, tendon and joint pain.
