The key to fast and effective treatment is an accurate and timely diagnosis. When a patient comes to our Sports Medicine office with pain, before we can do anything, we need to know: Is it a strain? Is something torn? Is this pain a part of a larger problem?
Fortunately, we are armed with a wide range of leading-edge tools to help us make an accurate diagnosis so we can start effective treatment as soon as possible.
One of the most effective—and easiest to use—tools is a musculoskeletal (or MSK) ultrasound. An MSK ultrasound uses existing ultrasound technology, but it is a specialized exam that looks specifically at soft tissue acute and chronic conditions. MSK ultrasound technologists have special training in looking at muscles, some ligaments, nerves and tendons.
Ultrasound is a test that uses reflected sound waves to produce an image of muscles, tendons, ligaments, nerves and joints throughout the body. It does not use X-rays or other types of possibly harmful radiation.
In addition to being safe, it’s easy and painless. This procedure requires little to no special preparation for patients. Just wear loose clothing and remove any jewelry. In some cases, you may be asked to wear a gown.
Otherwise, ultrasound imaging is faster than magnetic resonance imaging (MRI), usually completed within 15 to 30 minutes. And it does not require the patient to remain completely still, nor is it claustrophobic for patients.
Ultrasound images are typically used to help diagnose:
- Tendon tears or tendinitis
- Muscle tears, masses or fluid collections
- Ligament sprains or tears
- Inflammation or fluid in the joints
- Early stages of rheumatoid arthritis
- Carpal tunnel syndrome
Ultrasound is also used to allow sports medicine physicians to do injections safely and more accurately. Injections are used to deliver anesthetics, anti-inflammatories, regenerative medicine treatments and other medications precisely to affected areas.
How It’s Performed
For ultrasound testing, a gel or oil is applied to the skin to help transmit the sound waves. A small, handheld instrument called a transducer is passed back and forth over the area of the body that is being examined. The transducer sends out high-pitched sound waves (above the range of human hearing) that are reflected back to the transducer.
A computer analyzes the reflected sound waves and converts them into a picture that is called a sonogram, echogram or ultrasound.
Depending on the body part examined, you may be seated on an examination table or a swivel chair. For some exams, you may need to lie face-up or face-down on an examination table.
There is usually no discomfort. However, if scanning is performed over an area of tenderness, you may feel pressure or minor pain.
Once the imaging is complete, the clear gel will be wiped off your skin. Then you’re done.
A radiologist, a doctor trained to supervise and interpret radiology exams, will analyze the images. The radiologist will send a signed report to the doctor who requested the exam. Your doctor will then share the results with you. In some cases, the radiologist may discuss results with you after the exam.
MSK ultrasound is becoming a widely used tool for most sports medicine doctors. Athletes often need to obtain a quick and accurate diagnosis. This type of imaging can be used for very common injuries found in sports such as muscle strains, tendon issues, joint pain, bursitis and some bone injuries.
Research shows that MSK ultrasound is very effective to monitor the severity and progress of an injury. As a result, it’s become an important tool to determine if an athlete can return to play.
X-ray and MRIs will continue to be important tools used by orthopaedic specialists and sports medicine professionals. MRIs are excellent for visualizing internal structure of bones or certain joints. X-rays will continue to be used to examine dense tissues in the body, such as bones.
However, MSK ultrasound testing remains a very effective diagnostic tool that is widely available, easy-to-use and less expensive than most other imaging methods. It is safe and does not use radiation, but gives doctors a clear picture of soft tissues.
If you are suffering a sports-related orthopaedic condition and injury, our specialists—using hands-on examination and latest diagnostic tools—will diagnose your condition and develop the best care plan to get you back on your feet.
Kush Patel, MD, and Steven Collina, MD, are sports medicine physicians with the UPMC Pinnacle Bone and Joint Center. For more information, visit www.UPMCPinnacle.com/MSK.