Although ultrasound has been used for decades in physical therapy as a modality to deliver deep heat, recent advances in high-resolution ultrasound imaging present new opportunities for improving the care of patients with musculoskeletal injuries. Ultrasound uses sound waves to provide real-time, high-resolution images of tendons, ligaments, muscles, and nerves throughout the body. It is now being used in the outpatient setting to evaluate soft tissue abnormalities such as tendon or ligament tears, (i.e. rotator cuff tears), other tendinopathies, inflamed bursa, compressed nerves, carpal tunnel syndrome, popliteal cysts, and joint fluid.
Musculoskeletal ultrasound is an effective tool for diagnosing problems in patients with difficult-to-evaluate conditions. For example, in a patient with ankle pain, to determine whether a tendon tear is the problem, the physiatrist can use ultrasound to precisely inject anesthetic into the tendon sheath and assess the patient's response.
Ultrasound can also help diagnose the source of painful movement-related “noises”. By evaluating patients while they demonstrate their symptoms, physiatrists can identify unstable tendons, calcification formations within tendons, and other sources of pain caused by movement.
The use of musculoskeletal ultrasound also allows for the improved placement of needles into joints, tendon sheaths, or around nerves, for delivery of treatment without exposure to ionizing radiation. During ultrasound-guided injections or aspirations, physiatrists can directly visualize the needle passing to the target. Direct visualization ensures accurate placement and offers a greater margin of safety. Smaller needles may also be used, improving patient comfort and potentially reducing risk.