What Is Musculoskeletal Ultrasound?
Musculoskeletal ultrasound (also MSK ultrasound or musculoskeletal sonography) is a diagnostic tool that uses sound waves to create images of the musculoskeletal system: muscles, bones, ligaments, tendons, cartilage, and other connective tissue. Musculoskeletal ultrasound serves a dual purpose at Asheville Regenerative Orthopedics & Sports Medicine. We use it to diagnose conditions of and problems with the musculoskeletal system, as well as to guide injections more accurately.
"Excellent treatment and results, Had 3 rotator cuff tears which Dr. Lehman treated with plasma and stem cell injections. 4 months later no pain and full range of motion! Much better option than surgery! Highly recommend Dr. Lehman and her expertise."- Anonymous / Vitals / Dec 05, 2020
"Dr. Lehman is Awesome!, Several months ago I started having pain in my hips, to find out later, I have acute bursitis and a tare on my tendon. After trying cortisone and other shots to relieve the pain, I spoke with Dr. Lehman about my problem and we decided to try platelet gel. It has been 3 weeks since my platelet gel injection in my left hip and it has really helped! I recommend platelet gel to treat joint pain, bursitis, and many other sore spots you may have. Thank you so much Dr. Lehman for your time and help."- Anonymous / Vitals / Dec 04, 2020
"Reovered use of shoulder without surgery and extensive recovery time, how thrilled I am with how the stem cell/platelets treatment you provided has restored my shoulder rotator cuff tear to 85% or better of former use! I recently chain sawed and stacked about 20 logs for firewood, happily dig in the garden, lift heavy objects, and can even sleep on that shoulder."- Anonymous / Vitals / Sep 28, 2020
"Wonderful person, doctor and treatment!, After three cortisone injections into my shoulder over a 12 month period, it was time to go the next step and have the stem cell/PRP procedure. Now, three months later my shoulder is dramatically improved. Not sure how long it will be relatively painless, but for now ,I’m very, very happy!"- Anonymous / Vitals / Sep 27, 2020
"First I must mention that I've never had to wait for my scheduled appointment. The staff members are very professional and efficient, Dr. Lehman is personable and I am never rushed. She listens carefully to what I feel I need to explain... and she explains everything to me so that I totally understand. The injections are delicately done.. I would recommend her highly to anyone in need of her type of services..."- B.I. / Healthgrades / Sep 18, 2020
How Is Musculoskeletal Ultrasound Performed?
Ultrasound uses a probe (also known as a transducer) to generate sound waves. The probe is placed against the body and high-frequency sound waves—much higher than the range of human hearing—are emitted into the body. The sound waves get reflected back to the probe by the structures of the body.
Then, using calculations involving the speed of sound (among others) the transducer recreates the structures of the body into two-dimensional images. Often, a special gel is used on the skin to provide a better connection between the probe and the body. The gel eliminates air pockets, which can block sound waves.
How Does Ultrasound Help Guide Injections?
A 2018 review of scientific literature suggests that ultrasound-guided injections are more accurate than injections without ultrasound (also known as landmark-guided injections). Accuracy is critical when performing stem cell or PRP injections. Tendons, for example, should be injected into the tendon sheath and not the tendon itself, while joints should be injected into the joint space and not the surrounding soft tissue—muscles, tendons, ligaments, or cartilage—that make up the joint.
The musculoskeletal ultrasound takes some of the guesswork out of finding the right place to inject a patient. Without ultrasound, doctors must use their experience and their knowledge of anatomy to make their best guess as to the best site for the injection.
Because everyone’s anatomy is slightly different—one person might have a longer tendon than another, for example—landmark-guided injections can be less accurate than the practitioner originally anticipated.
What Else Can Musculoskeletal Ultrasound Be Used For?
In addition to guiding injections, musculoskeletal ultrasound is an excellent diagnostic tool. It is less expensive than magnetic resonance imaging (MRI) and more versatile than X-rays, which only show bone and not soft tissue like muscles, tendons, ligaments, and cartilage.
At Asheville Regenerative Orthopedics & Sports Medicine, we use MSK ultrasound to help diagnose a variety of conditions, including:
- Cartilage injuries
- Ligament sprains
- Muscle strains
- Tendon tears
Dr. Lehman personally interprets the results of the MSK ultrasound and discusses them with the patient without the need to outsource findings to a radiologist. The result is a rapid, on-site diagnosis.
How Should Patients Prepare for a MSK Ultrasound?
Preparation for an MSK ultrasound is minor. Wear comfortable, loose-fitting clothing and remove all jewelry before the procedure. Try to remain as still as possible throughout the procedure, which usually takes 15 to 30 minutes.
What Are the Risks of Musculoskeletal Ultrasound?
Ultrasound is a safe, well-tolerated procedure with no known risks. It is one of the most common diagnostic techniques used on pregnant women, so there is no risk of harm to a pregnant woman or her unborn child.
While MSK ultrasound carries no risks, there are limitations. Sound waves can have difficulty penetrating bone and can only penetrate the outer layer, so for some suspected conditions, another imaging scan such as an X-ray or MRI may be more effective.
Additionally, the deeper within the body, the more difficulty ultrasound has in depicting it. Very deep muscles, such as some in the lumbar region of the back or abdominal muscles such as the rectus abdominus may not be as clearly imaged as other structures closer to the skin.
For the most accurate, precise stem cell or PRP injection, or to get a diagnosis for your musculoskeletal condition, request an appointment at ARO today.