Point-of-care ultrasound in musculoskeletal field

Abstract

The musculoskeletal field is relatively new in point-of-care ultrasound (POCUS), a modality that has been gaining significance with the evolution of ultrasound (US) equipment and high-frequency probes. Images have become progressively clearer over the past decade, making it possible to diagnose many pathological conditions without exposure to radiation. Ultrasonography reveals many soft tissue pathologies that cannot be visualized using plain radiographs, which have historically been the first choice for the evaluation of musculoskeletal disorders. US saves money and time compared to magnetic resonance imaging (MRI). Although it is difficult to diagnose a disorder inside bone, its surface can be visualized very clearly, and it is also possible to visualize cartilage. Furthermore, with POCUS, it is possible to confirm a disorder and the continuity of the fibrous structures of muscles, tendons, and ligaments. In addition, the understanding of pathological conditions of motor disturbances, such as nerve or muscle/tendon injury, nerve paralysis, adhesions of the tendons, and joint instability, is deepened by observing the movement of these structures. Peripheral nerves, even small branches, can be visualized, and pathological conditions can be pinpointed by observing the nerve morphology, continuity, and relationship with the surrounding tissues. Children can be examined in a safe, relaxed environment, without leaving their parents. In addition, US is significantly different from other modalities in that it can be used for both diagnosis and treatment. Being able to visualize target sites improves safety and route accuracy of needle insertion for injection or puncture. Musculoskeletal POCUS is indispensable in routine medical care and is a technique that medical residents should acquire.

Keywords: Musculoskeletal (MSK); Nerve; Point-of-care ultrasound (POCUS); Tendon; US-guided treatment.