Liver transplant 7. Testes 8. Lower limb veins 9. Carotid Doppler Female pelvis Early pregnancy Nearly new ultrasound images show scanning technique, anatomy, and essential pathology. Newly revised information throughout helps you grasp essential concepts in diagnostic musculoskeletal ultrasound, ultrasound-guided musculoskeletal procedures, and much more. Thoroughly revised text, references, and images keep you up to date.
The book is divided into 23 chapters, beginning with the physical principles of ultrasound imaging. Subsequent chapters cover the sonography of particular anatomical structures of the musculoskeletal system, from muscle, ligaments and tendons, to peripheral nerves, skin and bone. Later chapters cover the sonography of broader anatomical areas, including shoulder, arm and hand, leg and foot, chest and abdominal wall. This edition of Musculoskeletal Ultrasound reflects the rapid growth of this technique, with more information on ultrasound anatomy, indications for ultrasound examinations, pathology and signs of disease.
A new glossary has been included with important terminology. The text is written at a level suitable for both students and more experienced practitioners, and has been edited by experienced sonographers working in consultant practice and education.
It covers basic ultrasound anatomy and normal variants, common pathology, how to report, and differential diagnoses processes. With contributions from leading musculoskeletal sonographers and a physiotherapist, and with input from radiology and rheumatology, this book provides a rounded, evidence-based resource for anyone wishing to incorporate musculoskeletal ultrasound into their practice. Accessible, step-by-step approach to support understanding Highly illustrated, ultrasound images included throughout Tips to help the reader problem solve and avoid common pitfalls.
Ideally suited for surgeons, sonographers, radiologists, technologists, oncologists, and endocrinologists, this brand new resource offers comprehensive coverage of sonographic anatomy for the head and neck region and presents the reader with well over 1, images for quick, clear reference. Diagnosis section offers 41 brand-new chapters on specific diagnoses in the head and neck region, from common to rare.
Over 1, images — including shear wave elastography and strain images — are complete with comprehensive annotations, and a "Key Facts" box is ideal for rapid review. Lists expert differential diagnoses on various pathological disease patterns. Expertddx section includes over images, many of which are brand new, and key references.
In addition, synovial and cartilage thickness can be accurately quantitated, providing an objective means of following patients with inflammatory arthritides. Ultrasound examination of deep-seated joints such as the hip and shoulder is especially valuable. Joint effusions, loose bodies, tendonitis, tendon and muscle ruptures can all be demonstrated with MSK Ultrasound. The non-invasive nature of the examination and lack of ionizing radiation make it very well accepted by patients, especially children.
Many older patients have never been to a doctor for anything more than cold or flu symptoms. Now as they age, things start to hurt. How about the aching shoulder from a football injury that occurred more than forty years ago?
Or the knees or elbows that hurt and is swollen? Hand and wrist pain because of hours spent on the home computer or from job related stress over many years.
On the other side of the coin, the older patient may have a history, because of bad genetic luck, of extensive medical treatment for complications of diabetes, heart and lung diseases, joint replacements, surgical procedures, etc. As a result many of these patients have been exposed to large amounts of ionizing radiation from x-rays. Possibly their spines are rigid and they cannot remain in a supine position for any long period of time. How about implanted devices such as pacemakers, defibrillators or other life saving devices?
What about total joint replacements or patients that are simply claustrophobic? The good news is that for all of those special patients MSK Ultrasound is the perfect diagnostic tool as it has no contraindications to its use, does not use Ionizing radiation and can be performed with a patient sitting comfortably in a chair. Everything is performed in your office. Establishing a treatment program for a now clearly identified condition can begin immediately.
It is important to note that as the population ages there will be increasing numbers of patients who will present with joint pain symptoms. Many of these patients may not have had any significant past joint pain problems. Forward thinking doctors are accepting the reality of those numbers and adjusting their practices to care for those patients. Having MSK Ultrasound in your practice for that group is essential for all of the previously stated reasons.
MSK Ultrasound of the shoulder, particularly of the rotator cuff is one of the most common examinations performed today. Third only to low back pain and carpal tunnel syndrome, shoulder pain is extremely common, especially in patients over the age of Ease of access to the shoulder joint allows for the investigation of many disorders and specific applications, including:. Patients suffering from rotator cuff disease typically complain of a dull, chronic ache in their shoulder, which prevents them from raising their arm i.
Many patients have difficulty sleeping on the affected side. While relatively uncommon before the age of 30, rotator cuff tears become increasingly common with age and are present in the majority of the population over the age of MSK Ultrasound examination of the elbow is often directed more by patient symptoms i.
The following are the most common general applications for MSK Ultrasound of the elbow:. In seven views, they were able to image the structures of the elbow in patients over a widerange of ages, from several months to 45 years. Because MSK Ultrasound allows visualization of cartilage that may not be visible with radiography, it has been found particularly helpful in the examination of infants and children.
Characteristic findings in tennis elbow see following discussion have been reported, consisting of hypoechoic extratendinous collections in muscle tears, fluid collections adjacent to the extensor carpi radialis brevis in bursitis, and alterations of tendon echogenicity and size in enthesopathy and tendinosis.
Such tendinosis is characterized by thickening and a diffuse decrease in echogenicity of the tendon. Frank tears can also be identified. Acute exacerbations of lateral or medial epicondylitis or tendon tears are associated with increased vascularity when power Doppler methods are used.
Tears of the biceps tendon can also be recognized, and the degree of tendon retraction in cases of complete disruption can be documented 8 Resnick. Neurovascular structures, especially the ulnar nerve, can also be assessed with MSK Ultrasound.
Normally, the ulnar nerve is located in the cubital tunnel and, in the longitudinal plane, contains linear hyperechoic strands 9 Resnick. Focal enlargement of the nerve and decreased echogenicity are typical of neuritis, and subluxation of the ulnar nerve can be promoted when provocative positions of the elbow are employed. Patients usually require a MSK Ultrasound examination of the hand and wrist to evaluate the origin of localized swelling or to diagnose tendon pathology.
Other soft tissue masses, listed in order of frequency, include:. The following are common diagnostic and general indications for MSK Ultrasound testing of the hand and wrist:.
Fornage and associates demonstrated that the normal tendons of the hand can be visualized by MSK Ultrasound Fornage. Inflammatory abnormalities, including foreign bodies and tenosynovitis, can also be visualized with MSK Ultrasound. Jeffrey and associates reported on eight patients with acute suppurative tenosynovitis.
The affected tendons were 25 percent larger than contralateral structures. In five of six cases, hypoechoic areas adjacent to symptomatic tendons contained purulent material. Ganglion cysts of the wrist are seen as well-marginated, multilobulated, hypoechoic masses that are easily differentiated from other abnormalities such as lipomas or aneurysms. Within the carpal tunnel, the normal median nerve reveals multiple hypoechoic nerve fascicles surrounded by the hyperechoic perineurial structures.
In general, if the nerve measures 0. Dynamic motion MSK Ultrasound accomplished as the patient flexes the fingers can contribute to the accurate diagnosis.
Tenosynovitis and ganglion cysts are among the causes of carpal tunnel syndrome that can be evaluated with MSK Ultrasound.
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