About Diagnostic Musculoskeletal Ultrasound
Ultrasound uses sound waves to create live images of the soft tissues under the skin. Unlike an MRI, it lets your physician scan while you move a joint, bend a finger, or contract a muscle, which can reveal problems that only appear with motion, such as a snapping tendon or a nerve that shifts out of place.
Both Dr. Gruner and Dr. Chen hold advanced credentials in musculoskeletal ultrasound and perform the scans themselves. Because the physician examining you is the one holding the probe, the scan can be tailored to exactly where it hurts, and you can see the images and ask questions as they appear.
Ultrasound is especially good for tendons, ligaments, muscles, small joints, and nerves. It does not see inside bone or deep in some joints as well as MRI, so we order other imaging when it will change your care.
What happens during treatment
- 1.
Your physician reviews your history and does a hands-on exam to decide which areas to scan.
- 2.
A small amount of gel is applied, and the probe is moved over the painful area and the same area on the other side for comparison.
- 3.
You may be asked to move the joint or tense a muscle so the physician can see how structures behave in motion.
- 4.
Your physician explains the findings with you during or right after the scan and outlines a treatment plan.
Who may be a good candidate
- People with tendon, ligament, muscle, or joint pain who want a clear answer at the first visit.
- Athletes and active people with a new injury who want to know how serious it is.
- People with numbness, tingling, or a suspected pinched nerve in the arm or leg.
- Patients who cannot have an MRI, such as those with certain implants, or who feel uncomfortable in an MRI scanner.
Recovery
There is no recovery time. You can drive, work, and exercise right after the scan. The gel wipes off, and there are no after-effects.
Risks and limits
Diagnostic ultrasound has no known risks at the settings used for musculoskeletal imaging and uses no radiation. Its main limit is what it can see: ultrasound does not look inside bone and may not fully show deep joint structures such as the inner hip or knee cartilage and meniscus. When a finding needs more detail, we will recommend an MRI, X-ray, or other test.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Clinical evidence
Published studies our physicians draw on. Results in studies do not predict any one person's outcome.
Questions about MSK Ultrasound
- Are ultrasound-guided injections more effective than blind injections?
- Yes. With ultrasound, your physician watches the needle reach the exact tendon, bursa, or joint space instead of aiming by feel. The American Medical Society for Sports Medicine (AMSSM) reviewed the published studies in its position statement on interventional musculoskeletal ultrasound and concluded that ultrasound-guided injections are more accurate than landmark-guided (blind) injections, work better, and are more cost-effective.Source: AMSSM position statement on interventional musculoskeletal ultrasound (Finnoff et al., 2015)
- Is ultrasound as good as an MRI?
- For many tendon, ligament, muscle, and nerve problems, ultrasound performed by an experienced physician gives answers comparable to MRI and adds the ability to scan while you move. MRI is better for bone and deep joint structures. We use each where it helps most.
- Can I get an ultrasound at my first visit?
- In most cases, yes. Our physicians keep ultrasound in the exam room, so a scan can be part of your first appointment when it will help answer your question.
- Does a musculoskeletal ultrasound hurt?
- No. The probe presses gently on the skin with a layer of gel. If the area is tender, you may feel some pressure, and the physician can adjust as needed.