2024 Workshop Handout Bundle-W81A Basic US of the Lower Limb Nerves Strakowski

W81A Basic US of the Lower Limb Nerves Strakowski

Pdf Summary

Musculoskeletal (MSK) Ultrasound (US) is a diagnostic tool utilizing sound waves to detect pathologies in tendons, ligaments, joints, muscles, and nerves. It is distinguished from Neuromuscular Ultrasound (NMUS), which focuses on disorders of the peripheral nervous system. MSK US offers excellent spatial resolution, lower costs compared to MRI, no radiation risks, real-time dynamic evaluation, and point-of-care use, but it requires operator expertise and may not fully evaluate joint derangements or structures obscured by bone.<br /><br />High-frequency linear array transducers are generally preferred for MSK US, with specific movements such as sliding, toggling, and rotation necessary for optimal imaging. Proper transducer handling and stabilization, especially during dynamic movements, is crucial. Recognition of tissue-specific sonographic appearance is also key, characterized by terms like hypoechoic (dark), hyperechoic (bright), and anechoic (black). Understanding the degree of anisotropy, or artifact due to non-perpendicular transducer positioning, is also essential, as tissues like tendons are highly anisotropic.<br /><br />Tendon pathologies, including ruptures and degenerative tendinosis, are prominent in MSK US. Tendonopathies typically show enlargement, hyperechogenecity, and altered architecture, while tendon tears display atrophy and distinct demarcation. The role of the examiner is to determine the extent and nature of these conditions.<br /><br />Practical tips for getting started with MSK US include using machine presets for musculoskeletal settings, adjusting depth settings appropriately, ensuring patient and operator comfort, imaging structures in both short and long axes, performing full joint protocols, using split-screen comparisons, and correlating findings with clinical data. Basic checklists are provided for scanning various joints in the upper and lower limbs, ensuring comprehensive coverage and accurate diagnosis.<br /><br />This summary, derived from a workshop handout, underscores the importance of technique, knowledge, and practice in mastering MSK Ultrasound for effective clinical application.

Keywords

Musculoskeletal Ultrasound

MSK US

tendon pathologies

high-frequency transducers

anisotropy

dynamic evaluation

tendon tears

hyperechoic

tendinosis

clinical application