Musculoskeletal Sonography

Musculoskeletal sonography is a way to image patients non invasively with sound waves, any patient can have a musculoskeletal sonography, patients, who have been ineligible for MRI because they have pacemakers or they have certain kinds of metallic implants in their body or they are claustrophobic or perhaps too large to be compatible with an MRI can have an sonography and so it’s particularly good to look at soft tissue structure, particularly peripherally like rotator cuff or tendons and lignins in the hands and the fingers, the foot and ankle and it’s really good to look at patients who are post operative, who maybe have metal implants in and around the knee or the shoulder who might have too much artefact caused by those implants for a CT and MRI.

Patients find it really comfortable to tolerate because they can just sit down and have the examination, they don’t need to lie particularly still for it, they don’t need to hold their breath; it’s a very comfortable experience for them.

Sonography

Sonography should not be used to look at patients who have bone tumours because they beam cannot penetrate the bone to the degree that MRI can or CT scan and in addition, sonography is not the first line to look for patients with internal derangements of the knee, patients with ligament tears in the knee and sonography should not be used to look at tears in the shoulder or the hip, MRI is really going to be the first line for that but in older patients who have a focused complaint let’s say, the biceps, tendon or of the rotator cuff where clinically, the doctor really suspects that that is the condition, sonography would be a very useful first line test for that.

Conclusion

It’s a very important tool for diagnosis because it’s quick to do, it’ relatively easy to do and it’s very cost effective and it also provides a very nice way for the doctor to interact with the patient, the patient finds out immediately what’s going on with them and they get direct feedback from the doctor, another great thing is that you can do dynamic imaging so you can image exactly where the patient hurts, you can bring them through the range of motion that recreates the pain and you can provide therapy on the spot so you can inject medication into a tendon sheet, you find the problem and provide immediate relief so sonography can directly guide the intervention and the patient walks away extremely happy.