Musculoskeletal Ultrasound for Sports Injuries and Joint Pain.

Musculoskeletal ultrasound is often the next step when a shoulder will not settle, a knee swells after a run or a tendon hurts every time you lift your arm. An X-ray often comes back normal in these cases, because X-rays show bone, not soft tissue. This post explains what the scan shows, when doctors order it and what the appointment involves.

Quick Facts: MSK Ultrasound

MSK ultrasound uses sound waves to image muscles, tendons, ligaments, joints and other soft tissue in real time, with no radiation. It requires a requisition from your doctor or nurse practitioner. Exams include the shoulder, knee, elbow and wrist, and ankle and foot.

MSK ultrasound looks at the structures that move and support your body: muscles, tendons, ligaments, joints and the soft tissue around them. It can show tears, inflammation, fluid and swelling that an X-ray cannot, and a radiologist reviews the images to produce your report.

Doctors often order an MSK ultrasound for sports injuries, tendon tears or inflammation, joint pain or swelling, muscle injuries, and soft tissue abnormalities such as lumps or fluid collections. It is commonly used for the shoulder, knee, elbow, wrist, ankle and foot.

The two tests answer different questions. An X-ray is the usual choice for fractures, dislocations and arthritis changes in the bone, while ultrasound is better suited to soft tissue. Your doctor chooses based on your symptoms and examination, and some patients have both. If your problem has not been explained by one test, a different one may be the next step.

One advantage of ultrasound is that it is dynamic. The technologist can watch the tissue while you move the joint, which can show a problem that only appears during certain movements. You may be asked to bend, rotate or lift the limb during the scan.

You will be seated or lying down with the area exposed. A water-based gel is applied and the technologist moves a handheld probe over the area, sometimes comparing it with the other side. The exam is painless, though pressing on a sore spot can be uncomfortable, so say so if it is.

Wear loose clothing that lets the area be reached easily, such as shorts for a knee exam or a sleeveless top for the shoulder. Bring your requisition and Ontario health card, and any earlier imaging reports if you have them. Follow the instructions you are given at booking. The report goes to your referring provider. For all of our ultrasound exams, see the ultrasound service page.

Does musculoskeletal ultrasound hurt? The scan itself is painless, although pressing on an already sore area can be uncomfortable.

Which joints can be scanned? Our exams include the shoulder, knee, elbow and wrist, and ankle and foot, as well as tendons and ligaments.

Do I need a requisition? Yes. Your doctor or nurse practitioner provides one. For general information on joint conditions, the Arthritis Society Canada is a helpful resource.

Is there any radiation? No. Ultrasound uses sound waves only.

What should I wear? Wear loose clothing that gives easy access to the area being examined, such as shorts for a knee exam or a sleeveless top for a shoulder exam.

Who reads my musculoskeletal ultrasound? A radiologist interprets the images, and the report is sent to the doctor or nurse practitioner who referred you.

If you already have a requisition from your doctor, our team is ready to help.