Provider Information

Diagnostic musculoskeletal / joint ultrasound

Evaluation of patients with musculoskeletal symptoms:

• Joint (articular) pain and/or swelling and/or effusion and/or tenderness
• Peri-articular pain and/or swelling and/or tenderness
• Enthesal symptoms (sites where tendon and ligament attach to bone)
• Non-traumatic or posttraumatic regional musculoskeletal symptoms (e.g. pain, swelling, clicking) without clear localization
• Currently asymptomatic patients with prior established articular or peri-articular symptoms
• Articular or peri-articular symptoms in cases with difficult physical examination

Evaluation of regional neuropathic pain / suspected peripheral nerve entrapment:

• Median nerve at forearm and wrist (Carpal tunnel)
• Radial nerve at forearm
• Ulnar nerve at elbow (Cubital tunnel) and wrist (Guyon’s canal)
• Posterior tibial nerve at ankle
• Interdigital nerves (Morton’s neuroma)
• Peroneal nerve at fibular head

Evaluation of localized or diffuse muscle weakness

• Patients with inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis)
• Patients with crystal induced arthropathies (gout, CPPD)
• Patients with degenerative joint disease (osteoarthritis)

• Joint aspiration
• Non-synovial fluid aspiration (abscess, cyst)
• Aspiration of tophaceous mass

• Injections of medications into joints (steroid, viscous supplements)
• Injections of medications into tendon sheets, peritendons, perientheses
• Perineural injections (e.g. carpal tunnel, cubital tunnel, etc.)
• Injection of Dupyuptren’s lesions

• Needle tenotomy
• Barbotage /removal of calcium deposits

• Synovial biopsy

• Foreign body removal

• A1 pulley resection

B-mode examination

• Joint effusion, hemarthrosis
• Synovial thickening
• Damage to menisci (knees) and labral (shoulders, hips) joint structures
• Erosions of cortical bone
• Osteophytes
• Enthesophytes
• Avulsion fractures
• Chondrocalcinosis (aka CPPD deposition in TFC, intrinsic wrist ligaments, and femoral cartilage)
• Sodium urate deposits (tophi, “double contour” sign)
• Retinaculum and tendon pulley thickening, tears
• Tendon abnormalities (tears, tendonopathy, calcifications, impingement, subluxations)
• Fascial pathology (plantar, palmar)
• Ligament pathology (tears, sprains)
• Bursitis
• Loose and foreign bodies
• Cystic lesions, hematoma, abscess

Dynamic B-mode examination

• Impingement of tendons and bursa (e.g. rotator cuff)
• Subluxation and determining cause of the clicking /snapping of tendons (e.g. biceps, peroneus, iliotibial band or iliopsoas, extensor carpi ulnaris)
• Subluxation of nerves (e.g. ulnar nerve at elbow)
• Ligament tears and sprains (wrist, knee, ankle)

Power Doppler examination

• Synovial hyperemia / synovitis
• Tendon sheet hyperemia /tenosynovitis
• Tendon and ligament hyperemia / tendinitis
• Soft tissue hyperemia / cellulitis, panniculitis
• Enthesal hyperemia /enthesitis