/Elbow • Hip • Shoulder • Wrist • Hand • Finger • Knee • Foot/Ankle

Musculoskeletal Ultrasound

Ultrasound is a safe, noninvasive imaging modality that is used to collect information related to the muscles, joints, ligaments and tendons.

The same sonar principles that submarines, ships, bats and dolphins use for location purposes (e.g., echolocation) are used to make ultrasound imaging possible. Consider that, when a sound wave hits an object, it echoes (bounces back). Measuring these echoes provides information as to how far away an object is, as well as its shape, size and consistency (i.e., fluid-filled or solid). In the world of medicine, these sound waves can be used to detect changes in the contour, size and/or appearance of organs, vessels and tissues as well as to detect abnormal masses (i.e., tumors).

Who Needs It

A musculoskeletal ultrasound can be used to help diagnose a variety of conditions and injuries, including:

ligament tears or sprains;
degenerative changes related to arthritis;
tendinitis of the Achilles tendon (ankle) and the rotator cuff (shoulder) as well as other tendons;
a collection of fluid, masses and/or tears in the muscles;
effusions or inflammation within the joints;
tears in tendons;
fluid collection or swelling within the bursae;
cartilage injuries and disorders of the knee, shoulder, and hip;
ganglion cysts (a noncancerous, fluid-filled sac beneath the skin of the wrist or hand);
nerve entrapments (e.g., carpal tunnel syndrome, cubital tunnel syndrome, etc.);
cancerous (malignant) and noncancerous (benign) soft tissue tumors; as well as
foreign bodies trapped in soft tissues (e.g., glass, splinters, etc.).

How Does It Work

Ultrasound imaging is also referred to as sonography or ultrasound scanning. Prior to starting the ultrasound procedure, ultrasound gel is applied to the skin of the area being examined. For example, if Dr. Hackel suspects damage to the soft tissues surrounding the ankle, the ultrasound gel will be applied to this area and spread around with a probe (small transducer). The gel serves as a conductor for the high-frequency sound waves that will be transmitted into the body by the transducer as well as for the echoes that will be sent back to it. As the transducer is moved around the area being examined, it sends sound waves into the body and then receives the echoes as they return. As the sound waves bounce back to the transducer, a computer uses them to generate an image. The images obtained during an ultrasound scan show the structures of the extremities allowing for a quick inexpensive and painless diagnosis to be made at the initial patient’s office visit. Many times the need for an expensive MRI is no longer necessary to identify the patient’s problem.