MSK Ultrasound PDF

Musculoskeletal Ultrasound 1. Describe the indications for using bedside ultrasonography for evaluating suspected musculoskeletal pathology and guiding related procedures. a. Want to use the high frequency linear transducer and have MSK exam preset b. MUST be perpendicular to anatomy (avoid anisotro...

Musculoskeletal Ultrasound 1. Describe the indications for using bedside ultrasonography for evaluating suspected musculoskeletal pathology and guiding related procedures. a. Want to use the high frequency linear transducer and have MSK exam preset b. MUST be perpendicular to anatomy (avoid anisotropy–get distorted images in different views/angles) c. Compare to NORMAL side d. Indications: visualize small tears or joint instability 2. Identify the musculoskeletal anatomy imaged on ultrasound including: a. Subcutaneous fat: right under the skin? (She didn’t exactly say) b. Muscle: echogenic with linear bands in tissue (striations) c. Tendons: echogenic linear fibrillar texture bands attaching muscles to bones d. Bursa: thin anechoic line in joint e. Ligaments: echogenic linear structure attaching bone to bone f. Nerve: will have honeycomb appearance 3. Describe the correct scanning technique including probe selection and patient positioning when obtaining ultrasound images of musculoskeletal structures. a. Shoulder: looking at long head of biceps brachii tendon, have patient sitting with palm up and look in transverse view and long axis b. Supraspinatus tendon: Transverse view with patient in superman pose (hand in back pocket) and scan on anterior side (Supra–superman pose) c. Subscapularis: Transverse, anterior approach, have pt abduct forearm with elbow next to side with palm up d. Infraspinatus: posterior approach under scapular spine, pt seated with arm across chest (pledge of allegiance stance) i. Increasing depth in this view helps see the glenoid joint and labrum e. Wrist: palm face up and scan starting in middle of forearm and go distally to wrist to follow median nerve (transverse and sagittal/long axis) f. Finger: palm up (flexor) or down (extensor) to see tendons g. Knee: lift up a bit, still perpendicular to anatomy h. Ankle and foot: point notch to heel, plantar fascia should be 4mm indicates fasciitis e. Tears: have some anechoic features and blurry 5. Discuss the use of ultrasound for imaging during the following procedures: All to see more specifically where to aspirate, apply block, or relocate joint a. Fracture and Joint Relocation b. Arthrocentesis c. Fracture Hematoma Block