What is Ultrasound (US) Examination?
We have known ultrasound examinations in the medical world for a long time. Ultrasonography (US) is a diagnostic tool that is commonly used especially in the field of obstetrics to see the condition of the fetus in the womb of pregnant women and to see other organs in the stomach.
How does Ultrasound Work?
Ultrasound works by emitting ultrasound waves through a transducer with gel as mediator, then waves will be reflected back in the form of an image on a monitor screen so that we can see our internal organs in the monitor and can immediately find out the abnormality.
The first use of ultrasound waves in the medical world was in 1942 to diagnose brain tumors. The research of ultrasound have been increasingly developed including in the musculoskeletal field, to identify the musculoskeletal structure like muscles, joint cartilage, tendons, bones and soft tissues around the joints. The use of ultrasound at that time was not maximal due to technological limitations so that the resolution of the images obtained was not good and could not be used for real time examinations.
Why Ultrasound Examination is Important in Musculoskeletal Abnormality?
Musculoskeletal disorders are often associated with high expenditure from employers due to the absence of workers, loss of productivity and high number of health services, disability and compensation costs for workers.
Nearly 70 million doctor visits recorded in the United States, and nearly 130 million care visits including outpatient visits, hospitals and emergency rooms due to this disorder.
Musculoskeletal rehabilitation plays a role in diagnosing and treating patients with disorders, and disabilities due to illness, disorders or trauma to muscles, bones, joints and other soft tissues around the joints.
The purposes of the Musculoskeletal Rehabilitation program are to improve and restore functional capacity, reduce symptoms, and restore the patient’s ability to do normal activities before the injury or illness and to improve patient welfare.
The need for an accurate diagnosis before treatment is very necessary. In the past, Physical and Medical Rehabilitation Medicine only relied on basic understanding of anatomy, physical examination maneuvers and rarely used imaging techniques.
Sometimes some musculoskeletal disorders are difficult to confirm with physical examination only. For example, pain in the shoulder or knee joint can be caused by many parts of the area, and those parts are so close to each other. Usually, doctor will ask for supportive examination for muscles, bones, joints, cartilage of joints, tendons and soft tissues around the joint (musculoskeletal) cases, using X-ray, CT-scan or MRI and musculoskeletal ultrasound. Each type of examination has their advantages and disadvantages.
Some Complicated Body Parts in Musculoskeletal System
Currently, ultrasound is commonly used in musculoskeletal field to help diagnosing and to assist therapeutic measures in the form of musculoskeletal injections. Ultrasound helps to determine the part of the pain precisely because medical action will be very different for each part and each type and level of damage that occurs. So ultrasound helps to confirm the type of abnormality, the organ that has a problem and its location precisely.
This imaging modality is in great demand given its superiority over other imaging modalities in terms of availability and convenience, safety, and diagnostic potential. Various medical disciplines, especially those related to bones, muscles, joints and other soft tissues abnormalities, have used it a lot for different purposes and focus according to their needs.
Rheumatologists use ultrasound examinations to confirm a diagnosis of inflammation in the tendon and synovial (joints and joint membrane), bone and cartilage changes in joint inflammation (arthritis), to guide injection and to evaluate the patient's condition after a treatment.
Radiologists use ultrasound to find out and to confirm the diagnosis of all musculoskeletal disorders without therapy and intervention.
Neurologists use ultrasound to identify nerve abnormalities or problems and to guide interventions such as injection, nucleoplasty, etc.
The Physical and Rehabilitation Medicine Specialist uses ultrasound with the same purpose as the Rheumatology, Orthopedic and Neurological Specialists as mentioned, but also associated with assessing the tissue functions especially after receiving specific treatment.
Ultrasound Examination Indication in Musculoskeletal Abnormality
Some US indications in musculoskeletal abnormalities:
Ultrasound Examination Advantages
Ultrasound examination advantages in musculoskeletal:
Fluid Aspiration in Shoulder Joint and Baker Cyst behind the Knee and Drugs Injection Therapy Guided by Ultrasound
Ultrasound Examination Disadvantages in Musculoskeletal
When compared to its advantages and disadvantages, ultrasound examination in the musculoskeletal field is very useful and has become the second stethoscope or the preferred choice of examining tool for doctors in examining musculoskeletal cases, all musculoskeletal cases are indications for ultrasound examination.
Ultrasound examination (US) helps to accurately confirm the diagnosis so that the treatment given is appropriate. Research on shoulder injection, where organs are overlapping, and carried out by expert and experienced doctors, shows that the accuracy of injection without ultrasound is only 56%, while with ultrasound the accuracy reaches 94%.