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.
"I have arthritis in my SI joints which caused pain down my right leg at night. I was awake every two hours. Back surgery was not for me. I searched the internet for regenerative medicine and found Dr. Lehman. Dr. Lehman is an expert in regenerative medicine. She's compassionate and always available to answer my concerns. Dr. Lehman did PRP injections on my left side first and a month later the right side. It's been three months and the pain is only a slight ache. I'm convinced I will be pain free very soon. Highly recommend Dr. Lehman."- B.M. / Healthgrades / Feb 25, 2021
"Dr Lehaman takes pride in her practice . I can not reccomend her enough. She takes pride in her work and wants her patients to feel better. I wish I would have met her 2 years ago before all the other treatment I went through. I was so much better in 3 weeks and could use my arm again after 2 years of not being able to... I would give a 100 stars if I could"- D.S. / Google / Feb 17, 2021
"Had injection for Achilles pain with great results. Dr. Lehman immediately connects with you as a team player to get you well, kind, caring, knowledgeable, schedules her time as if you're the only patient in the office, not in a hurry, answers any and all questions, explains procedures and options, doesn't sell anything, just potential solutions to your pain, wish more family and internal docs would recommend Dr. Lehman as an option before recommending surgical specialists. Also a shout out to Jennifer in the front office for her efficiency in keeping things running smoothly. Thank you Dr. Lehman...grateful for you and your expertise!!"- R.W. / Google / Jan 19, 2021
"Dr. Lehman is the reason my 99 year old mother is still able to keep walking, relatively pain free. Because of her age, no one will perform surgery on my mothers knees. Dr. Lehman meet with mom about 3 years to discuss what can actually be done to help mom with her painful knees. Since that time, mom has been able to get fairly long term relief from the treatments Dr. Lehman has offered. Thank you Dr. Lehman, we owe you so much!!"- N.A. / Google / Jan 19, 2021
"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
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.
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.