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.
What Are The Benefits Of A Musculoskeletal Ultrasound?
- Creates a highly detailed image to map the body's internal structures
- Provides more accurate diagnoses of injuries and conditions
- Allows precision-guided injections of medications and therapies
- Procedure is safe and painless
- Musculoskeletal ultrasound shows images in real-time
- Resolution and detail is higher than an MRI (magnetic resonance imaging)
- Patients aren't exposed to harmful radiation like x-rays or CT scans
- Ultrasound can show images of soft tissue, unlike x-rays
Am I a good candidate for a musculoskeletal ultrasound?
Many patients experiencing constant pain or inflammation, whether joint or muscle related, might want to pursue musculoskeletal ultrasounds as a way to assist in diagnosing the underlying cause of pain. In addition, ultrasound-guided injections can provide an excellent way for your provider to ensure that they achieve high precision in injection sites. There are very few disqualifiers from this procedure, and we here at Asheville Regenerative Orthopedics & Sports Medicine encourage our patients to explore this as an option to either receive answers as to a more accurate diagnosis, a more precise injection, or both.
"For 30 years I have had knee pain related to an old football injury. I am in highway and heavy construction so im always on my feet working, walking slopes and ditch line. Obviously over the years I’ve worn my joints out . Dr Lehman provided me with the stem cell treatment and my life is changed forever ! Very caring , professional and informative Dr. She took care of me and I feel I’ve gotten the best medical treatment short of full replacement and that’s something I really don’t want . I’m 52 and active again . Thank you Dr. Lehman and your team for giving me a pain free life ! "- D.C. / Healthgrades / May 10, 2022
"Three months ago, Dr. Lehman did a stem cell treatment on my knee for a torn meniscus and arthritis. She and her staff provided a thorough explanation of what was involved in the procedure and what to expect in the days after. I am now 80% pain free and able to walk several miles and up and downstairs without discomfort. I highly recommend this practice."- Anonymous / Healthgrades / Oct 14, 2021
"I came to Dr. Lehman after being told by several orthopedic surgeons that I needed a total knee replacement for advanced osteoarthritis. She treated me with stem cell & plasma rich platelet injections harvested from my own body. My knee was significantly improved afterwards and I can walk without my old limp!"- N.M. / Google / Oct 03, 2021
"I am extremely satisfied with my experiences with Dr. Lehman. I've had two procedures done and everything was handled professionally. She is an excellent communicator, and answered any questions I've had. Her bedside manner during the procedures is excellent as well. I've given her name to more than one friend, and highly recommend her to anyone who has joint/muscle issues that may benefit from her expertise."- L.M. / Google / Aug 03, 2021
"I came to Dr. Lehman after enduring years of pain in my hips, especially my right hip. Previous corticosteroid injections, which would help for a few months, had ceased to be effective. Driving, standing, walking - everything had become very painful. Dr. Lehman’s exam revealed several sizable tears in the tendons of both hips. I received the regenerative platelet injections in each hip, directly into the tendon tears, to produce new cell growth to fill in the painful gaps/tears. At that time, my regular pain on a scale of 1 to 10 was: 4 or 5 in my left hip; 8 to 10 in my right hip. Today, after my 12 week checkup, I can honestly say that my left hip pain is usually nonexistent or, at most, a 1, and my right hip pain is no higher than a 2, maybe 3 after driving a long distance. That is like a 75 to 80% improvement for me, and we expect it to continue to improve. I am so grateful to Dr. Lehman and her team for helping me get past the pain and all the associated stress!"- D.K. / Google / Jul 21, 2021
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 bone marrow 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.
Musculoskeletal ultrasound FAQs
Who should get a musculoskeletal ultrasound?
An MSK ultrasound is a safe way for people of all ages and backgrounds to identify a wide range of conditions. It's even safe for pregnant women! If you have unexplained discomfort or suspect an issue with your muscles, tendons, ligaments, or cartilage, Asheville Regenerative Orthopedics & Sports Medicine may recommend a musculoskeletal ultrasound.
What happens after an MSK ultrasound?
Patients can resume their activities as normal after a musculoskeletal ultrasound. After your appointment, Dr. Lehman will review your results and let you know if any additional steps need to be taken. Everything is done on-site — so you won't have to schedule additional follow-up appointments.
Why choose your team for a musculoskeletal ultrasound?
Dr. Lehman has extensive training and experience in musculoskeletal ultrasounds, which allows him to provide a safe, accurate diagnosis for patients. Our clinic is proud to have worked with countless patients in need of imaging and diagnostic services. Feel free to call with any concerns about your MSK ultrasound.
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 bone marrow or PRP injection, or to get a diagnosis for your musculoskeletal condition, request an appointment at ARO today.