Musculoskeletal (MSK) ultrasound (US) is a rapidly growing field, with many applications that have been proven
clinically useful. With advancements in technology over the past decade,
the resolution of ultrasound equipment is now so good that US has become an
important complementary, and in some cases alternative, tool to MRI for MSK imaging.
US is a safe, well-tolerated, low cost imaging technique with no ionizing
radiation and few technical limitations. Claustrophobia and metallic implants
are not an issue, so every patient can get an US. High frequency US has better
spatial resolution compared to an MRI, and US really excels in its ability
perform real-time dynamic studies and interventions. US also allows easy comparison
with the contralateral side, which can help in identifying subtle
abnormalities. MSK US is regarded as being operator dependent, and there certainly is a long learning curve. Careful
attention to technique is critical to achieving a diagnostic study. For most MSK US imaging, high frequency linear transducers are necessary, 10 MHz or higher. Technical advances such as tissue harmonic
imaging, spatial compounding, and extended field of view all can contribute to
producing a diagnostic image. Many US manufacturers also have preset factory
settings for MSK imaging, and if these are available, they can help with image
optimization. With US, the examiner can ask the patient where he or she
hurts, and perform provocative maneuvers that reproduce the patient's symptoms,
while imaging in real time. Color or Power Doppler can also be used when blood
flow information is desired. Because every MSK structure has its normal signature
appearance, it is important to know these appearances to facilitate the detection
of pathology. In depth knowledge of MSK anatomy is also critical.
In this presentation, we review the signature US appearance
of MSK structures and demonstrate common musculoskeletal abnormalities.
