Ultrasound - Musculoskeletal

About Musculoskeletal Ultrasound

Ultrasound, also called sonography, is an exam that uses sound waves to obtain images of the inside of the body.

These high-frequency sound waves are far above the range of human hearing. Sound waves are aimed at a particular area of the body. The different body tissues reflect the waves back in varying degrees. The echoed waves are recorded and displayed as a continuous real-time image on a computer monitor.

Since ultrasound relies on sound waves rather than radiation to produce images, it is ideal in many settings. This imaging technique is becoming increasingly important in the diagnosis of medical conditions in many different organs and tissue. Musculoskeletal ultrasound is used to evaluate sports injuries and musculoskeletal conditions in the muscles, bones, joints, and related tissue.

Musculoskeletal ultrasound can also be used for interventional procedures, such as injections and aspirations. Fluoroscopy and CT scanning are often used for these procedures; however, in some circumstances ultrasound is more advantageous.

Advantages of Musculoskeletal Ultrasound over MRI

MRI has been the traditional imaging exam used to diagnose musculoskeletal conditions in the United States. Ultrasound has also recently become an excellent option due to advancements in ultrasound technology. Musculoskeletal ultrasound and MRI are starting to be viewed as complimentary exams, each with its own advantages and disadvantages.

Following are some advantages of using ultrasound rather than MRI:

• Enables the sonographer to evaluate an area in different positions, which can provide more information on which to base a diagnosis
• Allows for a more thorough evaluation of motion-induced symptoms since ultrasound can be performed as the patient is moving
• Can be easier to identify the specific source of a problem since the patient can give the sonographer feedback during the exam
• Allows the sonographer to compare tissue on both sides of the body in situations where that information would be useful
• Can detect some tiny abnormalities and small nerves that may be difficult to see on MRI
• Can be performed on patients who are medically unable to have an MRI (i.e. patients with pacemakers or metal implants)
• Is more comfortable for claustrophobic patients
• More cost effective when clinically appropriate

Advantages of Musculoskeletal Ultrasound for Interventional Procedures

There are also advantages to using musculoskeletal ultrasound for interventional procedures, rather than fluoroscopy or CT scanning, including the following:

• No radiation exposure
• No contrast needed
• Safe during pregnancy
• Various soft tissues and joints are better seen with ultrasound, increasing the accuracy of needle placements
• Can allow for the diagnosis and treatment of a condition during the same appointment
• May detect conditions that indicate a procedure should be avoided or delayed before the procedure is performed

MSK Ultrasound Expertise

Musculoskeletal ultrasound has not yet gained widespread use because it requires specialized training. The benefits may only be obtainable when the sonographer and radiologist are properly trained and experienced.

Staying on the leading edge, Invision Sally Jobe is one of the first in the Denver Metro area to invest in providing a team of radiologists and sonographers with the advanced specialty training needed to offer musculoskeletal ultrasound. Invision Sally Jobe also utilizes state-of-the-art diagnostic imaging equipment in their musculoskeletal labs, which is essential to offering the most innovative, effective exams currently available.

Our musculoskeletal radiologists are fellowship-trained with extensive experience in the diagnosis of abnormalities of the bones, joints, cartilage, ligaments, tendons and muscles. These specialists excel at the evaluation of sports injuries, trauma, arthritis and tumors of bone and soft tissue. Musculoskeletal ultrasound is an additional tool in their arsenal for efficiently diagnosing musculoskeletal disorders.

Sports Injuries and Musculoskeletal Conditions

While musculoskeletal ultrasound has many benefits, it is not the preferred exam in all situations. Following are some sports injuries and conditions for which MSK ultrasound may be a better diagnostic tool. Your doctor will determine the most appropriate procedure for your specific condition.

• Tendon tears and ruptures
• Ligament tears and strains
• Tears and other abnormalities in the muscles
• Blood or other fluid collections within the muscles, bursae, and joints
• Soft tissue tumors
• Rheumatoid arthritis
• Stress fractures
• Compressed nerves
• Hardware changes after orthopedic procedures
• Soft tissue healing after injury

Risks Involved in an Ultrasound

No radiation is used in this examination and there are no known health risks.

Scheduling, Insurance and Preparation

Insurance Coverage

Musculoskeletal ultrasounds are usually covered by insurance when ordered by a physician. Check with your insurance company to be sure. Please bring your insurance card with you to your exam.

Conditions to Let Us Know About

There are no conditions that you need to report prior to this exam.

Preparation Guidelines

Musculoskeletal ultrasounds require no advanced preparation.

Support for Children

If your child is having the exam, it is important that you provide emotional support for him or her before and during the procedure. If your child is old enough to understand, explain the procedure to him or her. Let him or her know that the exam won’t hurt. Also reassure your child that you will be able to remain in the room during the exam.

What to Expect

During the Exam

Here is generally what will happen during an MSK ultrasound:

1. You may need to partially disrobe or change into a gown, depending on the area that will be examined. You may use a secure locker for your personal items during your exam.
2. The sonographer will explain the procedure and answer any questions you have.
3. The sonographer will position you on a table or chair and apply a clear, warm gel to the skin. This gel helps the sound waves penetrate into your body.
4. The sonographer will move the transducer (a handheld device that produces and records sound waves) across the area to be imaged while watching a continuous image on a computer screen. You won’t feel any pain during the procedure, but you may feel some mild discomfort.
5. The sonographer may ask you to perform a particular motion while she images the area and ask you to describe what you feel.
6. The sonographer may image the corresponding area on the opposite side of your body for comparison.
7. The sonographer will help you remove any remaining gel.
8. You will change back into your clothes if necessary.

The sonographer may leave the room to show images to a radiologist. The radiologist may come in during the exam to watch the ultrasound or perform part of the exam personally.

An MSK ultrasound usually takes 30 to 60 minutes, depending on the area being imaged.

Additional Measures for Children

If the patient is a child, two adults may be in the ultrasound room with him or her.

After the Exam

Recovery

You can return to your normal activities immediately after your MSK ultrasound exam.

Exam Results

A board-certified radiologist experienced in the interpretation of musculoskeletal ultrasounds will analyze the data and results from your exam. If the patient is a child, the exam data will be analyzed by a radiologist experienced in the interpretation of pediatric musculoskeletal ultrasounds. The results will be reported to your physician. Your physician will pass the results onto you.

During the exam, our radiologists and technologists will be happy to answer questions about the exam itself; however, they will not immediately provide you with the results of your exam.

More Resources

AIUM® Accreditation

Invision Sally Jobe is an AIUM® (American Institute of Ultrasound in Medicine)-accredited provider of diagnostic Musculoskeletal (MSK) Ultrasound! To receive this prestigious designation, facilities must undergo a comprehensive and rigorous review to ensure they meet the highest standards in clinical excellence and patient care. We are proud and honored to offer this caliber of expertise and service to the Colorado community!

For more information about Musculoskeletal (MSK) Ultrasounds offered by Invision Sally Jobe, click here.

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