Musculoskeletal Ultrasound

Musculoskeletal ultrasound is a safe procedure that uses low-power sound waves. There are no known risks.

Ultrasound is a valuable tool, but it has limitations. Sound doesn’t travel well through air or bone, so ultrasound isn’t effective at imaging body parts that have gas in them or are hidden by bone, such as the lungs or head. To view these areas, your doctor may order other imaging tests, such as CT or MRI scans or X-rays.

What Happens During A Musculoskeletal Ultrasound?

• Gel is applied to your skin over the area being examined. It helps prevent air pockets, which can block the sound waves that create the images. This water-based gel is easy to remove from skin and, if needed, clothing.
• A trained technician (sonographer) presses a small, hand-held device (transducer) against the area being studied and moves it as needed to capture the images. The transducer sends sound waves into your body, collects the ones that bounce back and sends them to a computer, which creates the images.
• Musculoskeletal Ultrasound is a dynamic or movement-related image done in real time. This is where the magic of Musculoskeletal Ultrasound comes in. There are numerous cases where an athlete can only feel pain with movement, which can only be visualized on a test such as Musculoskeletal Ultrasound.
• MRI is what we call a “static image.” In fact, if you are in the MRI tube and move too much, the image will become useless due to motion artifact.
• Some injuries can be categorized as “instabilities” and visualized extremely well on Ultrasound when the patient’s tissue or joint is stressed.
• In an MRI, a slight dislocated joint might be visualized as edema and swelling around the joint, but on an Musculoskeletal Ultrasound you actually SEE the joint move out of place. It’s amazing to see and very confirmatory of this type of diagnosis.
• Patient feedback allows us to pinpoint a pain source at the time of the image
• Often on an MRI, a Vitamin capsule is used to mark the level of pain, but on Musculoskeletal Ultrasound, it is not uncommon to press on the skin at the “painful spot” and visualize a depression in the image at the same point, which confirms the pain generator in real time. In fact, non-symptomatic abnormalities are found all the time on imaging, but in a report, it is important to be able to highlight the pain generator so it can be treated accordingly.
• We can compare bilateral structures on the same testing day
  Comparing possible pathology on both sides is helpful in determining if the pathology is in fact, the pain generator. For example, on occasion, thickening of a tendon can be seen on both sides of the body regardless if symptomatic or not.
• On MRI, we are only able to view one side per imaging study, which can lead the doctor to an incorrect diagnosis or cause increased cost for the patient for follow up imaging.
• Long structures (like nerves and muscle) can be viewed in their entirety all in one test.
• This can be one of the best advantages of Musculoskeletal Ultrasound compared to MRI. MRI can only show a section of limb or the body. Musculoskeletal Ultrasound is a dynamic study that allows us to follow a structure all the way from its origin to its attachment. Nerve symptoms, like numbness in the fingers, can be the result of compression or swelling around the nerve anywhere along its course down the limb. The majority of its course can be evaluated with this image. The same goes for a muscle, such as the hamstring. It is common to feel tightness and pain along the course of the hamstring after a tear. An ultrasound can pinpoint the exact location and severity of the injury.

For more information contact our physical therapists at the center of Casper, WY, and Glenrock, WY