Created by Tessa Huiswaard
over 4 years ago
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Question | Answer |
What are the three types of skeletal muscle? | Endomysium Perimysium and Fasicles Epimysium |
What type of transducer is used for MSK ultrasound? | High-frequency linear transducer but can be changed to another transducer as scanning if not visualizing deep enough eg. ankle could have a hockey-sticked shaped transducer |
What is the scanning technique | Ask the patient where it hurts, what movement hurts & replicate it Target the examination to the problem area (eg. only knee and not whole leg) Compare to asymptomatic side Be mindful of anisotropy artifact |
Muscle Sonographic Appearance | Longitudinal: Hypoechoic with hyperechoic striations & tendinous fibre Transverse: Hypoechoic with septa seen as hyperechoic dots Musculotendinous junction appears more hyperechoic Muscle lined with echogenic fascia Can be seen as having triangular shapes to muscle layers with echogenic striations |
Tendon Sonographic Appearance | Echogenic Longitudinal: Fibrillar pattern –> fine echogenic lines Transverse: Finely punctate pattern 90-degree angle to transducer crucial otherwise leads to anisotropy |
Clinical Indications for MSK Ultrasound | Bursitis, tendon or muscle tear / rupture, muscle atrophy, calcific tendonitis, tendon dislocation, tendon tendinopathy, adhesive capsulitis, acromion-clavicular joint (ACJ) osteoarthritis |
Anisotropy Sonographic Appearance | As can be seen in the image, the tendon is two portions, information is lost in areas, the angle must be changed as the transducer is not 90 degrees |
Normal Knee Sonographic Appearance | Infra-patellar tendon scanned, nice and taut throughout the scan, all information can be seen |
Normal Achilles Tendon Sonographic Appearance | Scanned on post aspect, tendon can be seen have nice white striations extending through |
Muscle Tears Sonographic Appearence | Right vs left compared, right is normal and left is torn, edema can be seen with thickend skin, muscle is pushed down, scanning abnout 4cm in patient, lost striations, blunting of fibers, black of fluid in the fascia layer |
Tendon Tears Ultrasound Appearance | Discontinuity of fibres Focal thinning of the tendon Hematoma Bony fragments Unable to visualise the tendon (complete tear) |
Achilles Tendinopathy Ultrasound Appearance | Thickening of the tendon Altered echotexture – Tendon may appear hypoechoic & heterogeneous Loss of definition of tendon margins Vascularity on Doppler imaging Calcifications |
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