Skip to main content
Top
Published in: Current Reviews in Musculoskeletal Medicine 1/2008

Open Access 01-03-2008

Advances and utility of diagnostic ultrasound in musculoskeletal medicine

Authors: Paul H. Lento, Scott Primack

Published in: Current Reviews in Musculoskeletal Medicine | Issue 1/2008

Login to get access

Abstract

Musculoskeletal ultrasound (US) can serve as an excellent imaging modality for the musculoskeletal clinician. Although MRI is more commonly ordered in the United States for musculoskeletal problems, both of these imaging modalities have advantages and disadvantages and can be viewed as complementary rather than adversarial. For diagnostic US, relative recent advances in technology have improved ultrasound’s ability to diagnose a myriad of musculoskeletal problems with enhanced resolution. The structures most commonly imaged with diagnostic musculoskeletal US, include tendon, muscle, nerve, joint, and some osseous pathology. This brief review article will discuss the role of US in imaging various common musculoskeletal disorders and will highlight, where appropriate, how recent technological advances have improved this imaging modality in musculoskeletal medicine. Additionally, clinicians practicing musculoskeletal medicine should be aware of the ability as well as limitations of this unique imaging modality and become familiar with conditions where US may be more advantageous than MRI.
Literature
1.
go back to reference Jacobson JA. Ultrasound in sports medicine. Rad Clin NA 2002;40(2):363–86.CrossRef Jacobson JA. Ultrasound in sports medicine. Rad Clin NA 2002;40(2):363–86.CrossRef
2.
go back to reference Middleton WD, Payne WT, Teefey SA, Hildebolt CF, Rubin DA, Yamaguchi K. Sonography and MRI of the shoulder: comparison of patient satisfaction. AJR 2004;183(5):1449–52.PubMed Middleton WD, Payne WT, Teefey SA, Hildebolt CF, Rubin DA, Yamaguchi K. Sonography and MRI of the shoulder: comparison of patient satisfaction. AJR 2004;183(5):1449–52.PubMed
3.
go back to reference Hangiandreou NJ. AAPM/RSNA physics tutorial for residents. Topics in US: B-mode US: basic concepts and new technology. Radiographics 2003;23(4):1019–33. Hangiandreou NJ. AAPM/RSNA physics tutorial for residents. Topics in US: B-mode US: basic concepts and new technology. Radiographics 2003;23(4):1019–33.
4.
go back to reference Benzon HT, Katz JA, Benzon HA, Iqbal MS. Piriformis syndrome: anatomic considerations, a new injection technique, and a review of the literature. Anesthesiology 2003;98(6):1442–8.PubMedCrossRef Benzon HT, Katz JA, Benzon HA, Iqbal MS. Piriformis syndrome: anatomic considerations, a new injection technique, and a review of the literature. Anesthesiology 2003;98(6):1442–8.PubMedCrossRef
5.
go back to reference Smith J, Hurdle MF, Locketz AJ, Wisniewski SJ. Ultrasound-guided piriformis injection: technique description and verification. Arch PM&R 2006;87(12):1664–7. Smith J, Hurdle MF, Locketz AJ, Wisniewski SJ. Ultrasound-guided piriformis injection: technique description and verification. Arch PM&R 2006;87(12):1664–7.
6.
go back to reference Jackson DW, Evans NA, Thomas BM. Accuracy of needle placement into the intra-articular space of the knee. JBJS Am 2002;84A(9):1522–7. Jackson DW, Evans NA, Thomas BM. Accuracy of needle placement into the intra-articular space of the knee. JBJS Am 2002;84A(9):1522–7.
7.
go back to reference Henkus HE, Cobben LP, Coerkamp EG, Nelissen RG, van Arkel ER. The accuracy of subacromial injections: a prospective randomized magnetic resonance imaging study. Arthroscopy 2006;22(3):277–82.PubMedCrossRef Henkus HE, Cobben LP, Coerkamp EG, Nelissen RG, van Arkel ER. The accuracy of subacromial injections: a prospective randomized magnetic resonance imaging study. Arthroscopy 2006;22(3):277–82.PubMedCrossRef
8.
go back to reference Naredo E, Cabero F, Beneyto P. A randomized comparatibe study of short term response to blind injection versus sonographic-guided injection of local corticosteroids in patients with painful shoulder. J Rheum 2004;31(2):308–14.PubMed Naredo E, Cabero F, Beneyto P. A randomized comparatibe study of short term response to blind injection versus sonographic-guided injection of local corticosteroids in patients with painful shoulder. J Rheum 2004;31(2):308–14.PubMed
9.
go back to reference Rosenthal SJ, Jones PH, Wetzel LH. Phase inversion tissue harmonic sonographic imaging: a clinical utility study. AJR 2001;176:1393–8.PubMed Rosenthal SJ, Jones PH, Wetzel LH. Phase inversion tissue harmonic sonographic imaging: a clinical utility study. AJR 2001;176:1393–8.PubMed
10.
go back to reference O’Connor PJ, Grainger AJ. Ultrasound imaging of joint disease. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 245–62. O’Connor PJ, Grainger AJ. Ultrasound imaging of joint disease. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 245–62.
11.
go back to reference van Holsbeeck MT. Sonography of tendons. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 77–82. van Holsbeeck MT. Sonography of tendons. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 77–82.
12.
go back to reference Plasznik R. Sonography of the shoulder. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 463–513. Plasznik R. Sonography of the shoulder. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 463–513.
13.
go back to reference Rutten MJ, Jager GJ, Blickman JG. From the RSNA refresher courses: US of the rotator cuff: pitfalls, limitations, and artifacts. Radiographics 2006;26(2):589–604.PubMedCrossRef Rutten MJ, Jager GJ, Blickman JG. From the RSNA refresher courses: US of the rotator cuff: pitfalls, limitations, and artifacts. Radiographics 2006;26(2):589–604.PubMedCrossRef
14.
go back to reference Dinnes J, Loveman E, McIntyre L, Waugh N. The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders:a systematic review. Health Tech Assess 2003;7(iii):1–166. Dinnes J, Loveman E, McIntyre L, Waugh N. The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders:a systematic review. Health Tech Assess 2003;7(iii):1–166.
15.
go back to reference Jacobson JA, Lancaster S, Prasad A, van Holsbeeck MT, Craig JG, Kolowich P. Full-thickness and partial-thickness supraspinatus tendon tears: value of US signs in diagnosis. Radiology 2004;230(1):234–42.PubMedCrossRef Jacobson JA, Lancaster S, Prasad A, van Holsbeeck MT, Craig JG, Kolowich P. Full-thickness and partial-thickness supraspinatus tendon tears: value of US signs in diagnosis. Radiology 2004;230(1):234–42.PubMedCrossRef
16.
go back to reference McNally EG. Ultrasound of the rotator cuff. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 43–58. McNally EG. Ultrasound of the rotator cuff. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 43–58.
17.
go back to reference Martin-Hervas C, Romero J, Navas-Acien A, Reboiras JJ, Munuera L. Ultrasonographic and magnetic resonance images of rotator cuff lesions compared with arthroscopy or open surgery findings. J Shoulder Elb Surg 2001;10(5):410–5.CrossRef Martin-Hervas C, Romero J, Navas-Acien A, Reboiras JJ, Munuera L. Ultrasonographic and magnetic resonance images of rotator cuff lesions compared with arthroscopy or open surgery findings. J Shoulder Elb Surg 2001;10(5):410–5.CrossRef
18.
go back to reference Pang BSF, Ying M. Sonographic measurement of Achilles tendons in asymptomatic subjects. J Ultrasound Med 2006;25:1291–96.PubMed Pang BSF, Ying M. Sonographic measurement of Achilles tendons in asymptomatic subjects. J Ultrasound Med 2006;25:1291–96.PubMed
19.
go back to reference Fessell DP, vanHolsbeeck MT. Sonography of the ankle and foot. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 605–24. Fessell DP, vanHolsbeeck MT. Sonography of the ankle and foot. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 605–24.
20.
go back to reference Scheller AD, Kasser JR, Quigley TB. Tendon injuries about the ankle. Orthop Clin N Am 1980;11(4):801–11. Scheller AD, Kasser JR, Quigley TB. Tendon injuries about the ankle. Orthop Clin N Am 1980;11(4):801–11.
21.
go back to reference Patel S, Fessell DP, et al. Artifacts, anatomic variants, and pitfalls in sonography of the foot and ankle. Am J Roentgenol 2002;178:1247–54. Patel S, Fessell DP, et al. Artifacts, anatomic variants, and pitfalls in sonography of the foot and ankle. Am J Roentgenol 2002;178:1247–54.
22.
go back to reference Danielson P, Alfredson H, Forsgren S. Distribution of general (PGP 9.5) and sensory (substance P/CGRP) innervations in the human patellar tendon. Knee Surgery, Sports Traumatology, Arthroscopy 2006;14(2):125–32.PubMedCrossRef Danielson P, Alfredson H, Forsgren S. Distribution of general (PGP 9.5) and sensory (substance P/CGRP) innervations in the human patellar tendon. Knee Surgery, Sports Traumatology, Arthroscopy 2006;14(2):125–32.PubMedCrossRef
23.
go back to reference Alfredson H, Ohberg L. Sclerosing injections to areas of neo-vascularisation reduce pain in chronic Achilles tendinopathy: a double-blind randomised controlled trial. Knee Surg Sport Traumatol Arthrosc 2005;13(4):338–44.CrossRef Alfredson H, Ohberg L. Sclerosing injections to areas of neo-vascularisation reduce pain in chronic Achilles tendinopathy: a double-blind randomised controlled trial. Knee Surg Sport Traumatol Arthrosc 2005;13(4):338–44.CrossRef
24.
go back to reference Teh JL. Doppler imaging in the musculoskeletal system. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 263–82. Teh JL. Doppler imaging in the musculoskeletal system. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 263–82.
25.
go back to reference Fahlstrom M, Jonsson P, Lorentzon R, Alfredson H. Chronic Achilles tendon pain treated with eccentric calf-muscle training. [Comparative Study. Journal Article]. Knee Surg Sport Traumatol Arthrosc 2003;11(5):327–33.CrossRef Fahlstrom M, Jonsson P, Lorentzon R, Alfredson H. Chronic Achilles tendon pain treated with eccentric calf-muscle training. [Comparative Study. Journal Article]. Knee Surg Sport Traumatol Arthrosc 2003;11(5):327–33.CrossRef
26.
go back to reference McNally EG. Ultrasound of the foot and ankle. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 167–90. McNally EG. Ultrasound of the foot and ankle. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 167–90.
27.
go back to reference Neustadter J, Raikin SM, Nazarian LN. Dynamic sonographic evaluation of peroneal tendon subluxation. AJR 2004;183:985–8.PubMed Neustadter J, Raikin SM, Nazarian LN. Dynamic sonographic evaluation of peroneal tendon subluxation. AJR 2004;183:985–8.PubMed
28.
go back to reference Fleisig GS, Barrentine SW, Escamilla RF, Andrews JR. Biomechanics of overhand throwing with implications for injuries. Sports Med 1996;21(6):421–37.PubMedCrossRef Fleisig GS, Barrentine SW, Escamilla RF, Andrews JR. Biomechanics of overhand throwing with implications for injuries. Sports Med 1996;21(6):421–37.PubMedCrossRef
29.
go back to reference Fleisig GS, Andrews JR, Dillman CJ, Escamilla RF. Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med 1995;23(2):233–9.PubMedCrossRef Fleisig GS, Andrews JR, Dillman CJ, Escamilla RF. Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med 1995;23(2):233–9.PubMedCrossRef
30.
go back to reference Nazarian LN, McShane JM, Ciccotti MG, O’Kane PL, Harwood MI. Dynamic US of the anterior band of the ulnar collateral ligament of the elbow in asymptomatic major league baseball pitchers. Radiology 2003;227(1):149–54.PubMedCrossRef Nazarian LN, McShane JM, Ciccotti MG, O’Kane PL, Harwood MI. Dynamic US of the anterior band of the ulnar collateral ligament of the elbow in asymptomatic major league baseball pitchers. Radiology 2003;227(1):149–54.PubMedCrossRef
31.
go back to reference Gruber G, Nebe M, Bachman G, Litzlbauer HD. US as a diagnostic measure in the rupture of fibular ligaments. Comparative study: Sonography versus radiological investigations. Rofo Fortschr Geb rontgenstr Neuen bildgeb verfahr 1998;169(2):152–6.PubMedCrossRef Gruber G, Nebe M, Bachman G, Litzlbauer HD. US as a diagnostic measure in the rupture of fibular ligaments. Comparative study: Sonography versus radiological investigations. Rofo Fortschr Geb rontgenstr Neuen bildgeb verfahr 1998;169(2):152–6.PubMedCrossRef
32.
go back to reference Friedl W, Glaser F. Dynamic sonography in the diagnosis of ligament and meniscal injuries of the knee. Arch Orthop Trauma Surg 1991;110(3):132–8.PubMedCrossRef Friedl W, Glaser F. Dynamic sonography in the diagnosis of ligament and meniscal injuries of the knee. Arch Orthop Trauma Surg 1991;110(3):132–8.PubMedCrossRef
33.
go back to reference van Holsebeeck MT. Sonography of ligaments. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 171–92. van Holsebeeck MT. Sonography of ligaments. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 171–92.
34.
go back to reference Marchal GJ, Van Holsbeeck MT, Raes M, Favril AA, Verbeken EE, Casteels-Vandaele M, Baert AL, Lauweryns JM. Transient synovitis of the hip in children: role of US. Radiology 1987;162(3):825–8.PubMed Marchal GJ, Van Holsbeeck MT, Raes M, Favril AA, Verbeken EE, Casteels-Vandaele M, Baert AL, Lauweryns JM. Transient synovitis of the hip in children: role of US. Radiology 1987;162(3):825–8.PubMed
35.
go back to reference van Holsebeeck MT. Sonography of large synovial joints. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 235–76. van Holsebeeck MT. Sonography of large synovial joints. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 235–76.
36.
go back to reference Cooperberg PL, Tsang I, Truelove L, Knickerbocker WJ. Gray scale ultrasound in the evaluation of rheumatoid arthritis of the knee. Radiology 1978;126(3):759–63.PubMed Cooperberg PL, Tsang I, Truelove L, Knickerbocker WJ. Gray scale ultrasound in the evaluation of rheumatoid arthritis of the knee. Radiology 1978;126(3):759–63.PubMed
37.
go back to reference Hammer M, Mielke H, Wagener P, Schwarzrock R, Giebel G. Sonography and NMR imaging in rheumatoid gonarthritis. Scand J Rheumatol 1986;15(2):157–64.PubMedCrossRef Hammer M, Mielke H, Wagener P, Schwarzrock R, Giebel G. Sonography and NMR imaging in rheumatoid gonarthritis. Scand J Rheumatol 1986;15(2):157–64.PubMedCrossRef
38.
go back to reference van Holsbeeck M, van Holsbeeck K, Gevers G, Marchal G, van Steen A, Favril A, Gielen J, Dequeker J, Baert A. Staging and follow-up of rheumatoid arthritis of the knee. Comparison of sonography, thermography, and clinical assessment. J Ultrasound Med 1988;7(10):561–6.PubMed van Holsbeeck M, van Holsbeeck K, Gevers G, Marchal G, van Steen A, Favril A, Gielen J, Dequeker J, Baert A. Staging and follow-up of rheumatoid arthritis of the knee. Comparison of sonography, thermography, and clinical assessment. J Ultrasound Med 1988;7(10):561–6.PubMed
39.
go back to reference Sofka CM, Adler RS, Danon MA. Sonography of the acetabular labrum: visualization of labral injuries during intra-articular injections. J Ultrasound Med 2006;25:1321–6.PubMed Sofka CM, Adler RS, Danon MA. Sonography of the acetabular labrum: visualization of labral injuries during intra-articular injections. J Ultrasound Med 2006;25:1321–6.PubMed
40.
go back to reference van Holsebeeck MT. Sonography of muscle. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 23–75. van Holsebeeck MT. Sonography of muscle. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 23–75.
41.
go back to reference Nicholas JA, Hershman EB. The lower extremity and spine in sports medicine. St Louis: CV Mosby Co.; 1986. Nicholas JA, Hershman EB. The lower extremity and spine in sports medicine. St Louis: CV Mosby Co.; 1986.
42.
go back to reference Bianchi S, Martinoli MC, Boutry N. Ultrasound imaging of the hand and wrist. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 95–117. Bianchi S, Martinoli MC, Boutry N. Ultrasound imaging of the hand and wrist. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 95–117.
43.
go back to reference Yesildag A, Kutluhan S, Sengul N. The role of ultrasonographic measurementsof the median nerve in the diagnosis of carpal tunnel syndrome. Clin Radiol 2004;59:910–5.PubMedCrossRef Yesildag A, Kutluhan S, Sengul N. The role of ultrasonographic measurementsof the median nerve in the diagnosis of carpal tunnel syndrome. Clin Radiol 2004;59:910–5.PubMedCrossRef
44.
go back to reference McConnell JR, Bush DC. Intraneural steroid injection as a complication in the management of carpal tunnel syndrome: a report of three cases. Clin Orthop Rel Res 1990;250:181–4. McConnell JR, Bush DC. Intraneural steroid injection as a complication in the management of carpal tunnel syndrome: a report of three cases. Clin Orthop Rel Res 1990;250:181–4.
45.
go back to reference Quinn TJ, Jacobson JA, Craig JG, van Holsbeeck MT. Sonography of Morton’s neuromas. Am J Roentgenol 2000;174:1723–28. Quinn TJ, Jacobson JA, Craig JG, van Holsbeeck MT. Sonography of Morton’s neuromas. Am J Roentgenol 2000;174:1723–28.
46.
go back to reference McNally EG. Musculoskeletal interventional ultrasound. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 283–308. McNally EG. Musculoskeletal interventional ultrasound. In: McNally EG, editor. Practical musculoskeletal ultrasound. Philadelphia Elsevier; 2005. p. 283–308.
47.
go back to reference van Holsebeeck MT. Sonography of bursae. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 131–70. van Holsebeeck MT. Sonography of bursae. In: van Holsebeeck MT, editor. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby; 2001. p. 131–70.
Metadata
Title
Advances and utility of diagnostic ultrasound in musculoskeletal medicine
Authors
Paul H. Lento
Scott Primack
Publication date
01-03-2008
Publisher
Humana Press Inc
Published in
Current Reviews in Musculoskeletal Medicine / Issue 1/2008
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-007-9002-3

Other articles of this Issue 1/2008

Current Reviews in Musculoskeletal Medicine 1/2008 Go to the issue