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Musculoskeletal Ultrasound in Asheville, NC

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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.

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:

  • Bursitis
  • Cartilage injuries
  • Ligament sprains
  • Muscle strains
  • Tendon tears
  • Tendonitis

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.

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.