Musculoskeletal, Pelvis and Spine Diagnostic Ultrasound

Sean Mulvaney, M.D. RMSK

Background of Musculoskeletal, Pelvis and Spine Diagnostic Ultrasound

Musculoskeletal ultrasound is a painless and safe way to look through the skin at the muscles, tendons, ligaments and nerves in the body. Ultrasound can also see the surface of bones and some, but not all, cartilage surfaces because although it is an excellent way to image the body, ultrasound cannot see through bones. Ultrasound does not use harmful ionizing radiation like x- rays or CT scans. Diagnostic ultrasound has many advantages over other ways of imaging the body including MRIs. Ultrasound can be used to view a body part while it is moving or under tension; this is called a dynamic ultrasound exam. Ultrasound can also rapidly perform a comparison of an injured body part to the area on the other side of the body. Ultrasound can focus in on the exact area where a person hurts, and studies show it is as good as MRI for assessing many types of injuries. I was in the very first group of physicians to earn a specialized qualification (RMSK) in the use of musculoskeletal ultrasound. I have been teaching and lecturing to national and international physicians on diagnostic musculoskeletal, pelvis, and spine ultrasound and ultrasound guided procedures for over 10 years. I am a recognized expert in this field and it guides almost all of my treatments.

What to expect and how to prepare for a musculoskeletal ultrasound

There is no need to do any special preparation. If the clothing you are wearing gets in the way, we will give you a gown or some shorts to put on.

What happens during the musculoskeletal ultrasound?

During an ultrasound exam, many different images of an injured joint or area are recorded. You will be given instructions on how to position your body. It is painless. Some water-based, non- toxic, non-staining ultrasound gel will be placed on the skin in the area to be scanned. The gel will be wiped off once the scan is complete. An ultrasound probe, called a transducer, will be placed on your skin. The transducer has over 100 small piezo-electric crystals in it that send out faint sounds waves and then record the returning sound echoes from inside your body. The computer in the ultrasound machine interprets the returning sound echoes and forms the image on the ultrasound machine viewing screen. Flow within blood vessels can be seen using Doppler ultrasound. If you have questions about what is being viewed on the screen, just ask.

What to do after your procedure

There are no special instructions for after an ultrasound exam. We will discuss the findings with you during and after the exam. The findings from the ultrasound exam will help guide the options for the treatment plan. In some, but not all, types of injuries we may recommend a diagnostic ultrasound-guided injection of a small amount of a numbing medicine (lidocaine). Many of us have old injuries which do not cause us any pain, and just because something is seen on any medical imaging study does not necessarily mean it is causing your pain. An ultrasound diagnostic injection of a small amount of lidocaine can confirm that the injury we see is the same one that is causing you pain.