2025 Workshop Handout Bundle-W81C Basic US lower limbs- Duplechan

W81C Basic US lower limbs- Duplechan
Pdf Summary
This document serves as an introductory guide to Musculoskeletal Ultrasound (MSK US) authored by Dr. John Norbury and Dr. Jeffrey Strakowski. MSK US utilizes high-frequency sound waves to visualize pathology in tendons, ligaments, joints, muscles, and nerves, primarily focusing on orthopedic disorders. It offers advantages such as high spatial resolution, cost-effectiveness compared to MRI, no radiation exposure, ease of use at the point of care, and real-time dynamic assessment of conditions like snapping hip or shoulder impingement. However, its limitations include difficulty evaluating internal joint derangements (e.g., labral tears), structures obscured by bone, and a strong dependence on operator skill.<br /><br />High-frequency linear transducers are preferred for imaging, with specific hand and transducer maneuvers (sliding, rocking, tilting, rotation, compression) aiding optimal image acquisition. Recognizing tissue-specific sonographic patterns (hypoechoic, hyperechoic, anechoic) is crucial. Tendons exhibit fibrillar, hyperechoic architecture with notable anisotropy, while nerves display fascicular patterns, and muscles show pennate or "starry night" appearances. Anisotropy, an artifact caused by non-perpendicular transducer positioning, affects imaging, especially of tendons and ligaments.<br /><br />Common tendon pathologies encountered include degenerative tendinosis (tendonopathy) and tendon ruptures. Tendinosis presents as tendon enlargement, hypoechogenicity, loss of normal architecture, and increased Doppler flow, while tears reveal sharp delineations and possible tendon retraction.<br /><br />The guide provides practical principles for MSK US performance, including machine presets, patient/operator positioning, imaging protocols, and side-to-side comparison to enhance accuracy. Comprehensive checklists for imaging key structures in the upper and lower limbs help users build proficiency. Upper limb focus areas include biceps tendon, shoulder muscles, and wrist compartments. Lower limb protocols cover the hip (e.g., femoral vessels, sciatic nerve), knee (menisci, ligaments, nerves), ankle (tendons, ligaments, nerves), and foot (plantar fascia, Morton’s neuroma region).<br /><br />Reference materials and standardized guidelines from American and European societies are cited, supporting best practices in MSK ultrasound for diagnostic and interventional purposes.
Keywords
Musculoskeletal Ultrasound
MSK US
tendons
ligaments
joints
muscles
nerves
orthopedic disorders
high-frequency linear transducers
tendon pathologies