Diagnostic and Interventional Musculoskeletal Ultrasound: Part 2. Clinical Applications

Abstract

Musculoskeletal ultrasound involves the use of high-frequency sound waves to image soft tissues and bony structures in the body for the purposes of diagnosing pathology or guiding real-time interventional procedures. Recently, an increasing number of physicians have integrated musculoskeletal ultrasound into their practices to facilitate patient care. Technological advancements, improved portability, and reduced costs continue to drive the proliferation of ultrasound in clinical medicine. This increased interest creates a need for education pertaining to all aspects of musculoskeletal ultrasound. The primary purpose of this article is to review diagnostic ultrasound technology and its potential clinical applications in the evaluation and treatment of patients with neurological and musculoskeletal disorders. After reviewing this article, physicians should be able to (1) list the advantages and disadvantages of ultrasound compared to other available imaging modalities; (2) describe how ultrasound machines produce images using sound waves; (3) discuss the steps necessary to acquire and optimize an ultrasound image; (4) understand the difference ultrasound appearances of tendons, nerves, muscles, ligaments, blood vessels, and bones; and (5) identify multiple applications for diagnostic and interventional musculoskeletal ultrasound. Part 2 of this 2-part article will focus on the clinical applications of musculoskeletal ultrasound in clinical practice, including the ultrasonographic appearance of normal and abnormal tissues as well as specific diagnostic and interventional applications in major body regions.

Vascular structure and function in the medial collateral ligament of anterior cruciate ligament transected rabbit knees

“…US has been used to image joint tissues and ligaments by assessing collagen fibril organization, ligamentous thickness, and water content. 4,5 Loss of collagen fibril organization, increased ligament thickness, and hypoechoity-a measure of increased water content, are identify ligament degeneration and loss of mechanical strength. 6 This study hypothesized that angiogenic vessels in the MCL lack smooth muscle necessary for normal regulation of vascular tone and appear functionally as vascular and endothelial dysfunction in the MCL of ACL-t knees.…”

Untitled

“…It is notable that MRI is a costly diagnostic technique which has a long acquisition time, and mostly used for cases where TVUS and color flow Doppler are inconclusive [22]. Diagnostic hysteroscopy and diagnostic laparoscopy allows direct visualization and can be also therapeutic [20][21][22].…”

“…A cervical pregnancy is extremely rare in patients with previous cesarean delivery. Therefore, the differential diagnosis of a cervical pregnancy is mainly in patients with no history of cesarean delivery, heavier bleeding, presence of a layer of healthy myometrium visible between the bladder and the gestational sac [19] and gestational sac present within the cervix, giving an hour-glass shape to the uterus with a ballooned cervical canal on ultrasound [2,17,21]. In cases of a spontaneous miscarriage in progress, volume of bleeding is often greater due to detachment of a failed chorionic sac that is visibly seen in the cervical canal on TVUS, and on color flow Doppler, with the sac appearing avascular [23].…”

“…Occasionally, CSP can be misdiagnosed as a trophoblastic tumour if ultrasound scan indicates no evidence of pregnancy within the uterus but detects high vascularised mixed echo mass infiltrating the myometrium in presence of high serum β-hCG level. Diagnosis of CSP is relatively easy and early in pregnancy, but as it advances, the disparity between CSP, cervical pregnancy and low implanted intrauterine pregnancy becomes more difficult [4,21].…”

Akutdiagnostik von Sportverletzungen

“…For some injuries, delayed verification by MRI can be accepted while, for others, early MRI is essential for therapy initiation and to assure an optimal clinical outcome. [16]. Im Bereich des muskulotendinösen Übergangs ist hier jedoch das MRT sensitiver [5,8,9].…”