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Diagnostic Musculoskeletal Ultrasound - The Iphone of the 21st Century

Updated: Jan 2

Blog post by Dr Charles Stevens DPT, RMSK, COMT, CLT, AIB-VAM

Diagnostic musculoskeletal ultrasound is pain-free form of imaging that uses sound waves to visualize structures in the body. It is 1/17th the cost of an MRI and can be used to visualize muscles, tendons, cartilage, and soft tissues of the body. Musculoskeletal Ultrasound does not produce radiation or need a contrast medium. With no contraindications, it is considered the new “stethoscope of the 21st century”. For those with claustrophobia of MRI’s, musculoskeletal ultrasound is a great tool to image the body and allows for comfortable patient positioning and movement during the imaging.

Musculoskeletal ultrasound offers the unique opportunity to move the body part that is being visualized and allow for imaging in “real-time”. This can be beneficial to see impingement syndromes of the shoulder, meniscal tears of the knee, and other common orthopedic issues.

During the examination, gel is applied to the skin and the transducer is moved to visualize varying anatomic structures. The imaging is pain-free and the patient may be asked to move the body part during imaging to visualize how the structures in the affected area are moving.

With handheld ultrasound, you can improve patient management through improved patient management and streamlined decisions.

Recently, on diagnostic musculoskeletal ultrasound, I was able to locate a failed ORIF of a hip surgery that static CT scan, X Ray, and bone scan could not visualize. Due to the movement nature of diagnostic musculoskeletal ultrasound, I could visualize a screw tearing into the deep head of quadricep, the vastus intermedius, with every step the patient took. Upon this discovery, the patient's team of physicians was notified and the trajectory of his management greatly changed. I have posted the case below:

Diagnostic musculoskeletal ultrasound has value for dry needling and procedures on verifying you are treating the correct target, avoiding vasculature, and identifying cysts vs blood vessels by the use of power or color doppler. Additionally, this point of care service has value to locate gout, pseudogout, active inflammation via power doppler with hyperemia, and ability to help achieve patient compliance and satisfaction during a treatment plan of care. This is particularly important when screening for severe Tendinopathy or possible stress fracture prior to manipulation.

There is an art to learning diagnostic musculoskeletal ultrasound and one would want to work with a mentor who has years of experience in this field. Getting training in this hands on diagnostic tool is right for you if you are looking to locate the source of a patient's pain faster and achieve higher patient outcomes, have patients refer their friends and family to you, and become your local expert on diagnostic musculoskeletal ultrasound. Click the link below to learn more about this powerful point of care service and to begin training and adding this service to your practice.

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