Understanding MSK Ultrasound for Athletes

Most of us are familiar with MRIs and CT scans that help diagnose athletic injuries, but musculoskeletal ultrasound or MSK ultrasounds can be done in the office and are becoming the norm.

Andrew Hills, DO, an Indianapolis sports medicine specialist with Franciscan Health, discusses the benefits of MSK ultrasound for athletes.

What Is Musculoskeletal Ultrasound?

Musculoskeletal ultrasound is a diagnostic imaging technique that uses sound waves to visualize muscles, tendons, ligaments and other soft tissues. It helps assess injuries and conditions related to the musculoskeletal system by using sound waves and creating an image based off how those sound waves kind of change as it travels through our tissues.

"It's similar to what we learned kind of in grade school when bats are using kind of sonar to detect their prey," Dr. Hills said. "Probably the most popular environment that people are most aware of it is in OB-GYN when they're visualizing fetal development. And we're using the same technology in the sports medicine world to visualize muscles, tendons, ligaments and other soft tissue structures."

How Does Musculoskeletal Ultrasound Work?

During a musculoskeletal ultrasound, a technician applies a gel to the skin and uses a transducer to send and receive sound waves. These waves create real-time images of the structures beneath the skin, allowing healthcare providers to examine them for any abnormalities. The procedure is generally painless.

What Are The Benefits Of MSK Ultrasound For Athletes?

MSK ultrasound offers several benefits for athletes, including:

• Real-time imaging: Allows for immediate assessment of injuries during a physical exam.
• No radiation exposure: Safe for repeated use without the risks associated with X-rays or CT scans. "It makes it a safer option for pregnant women and children," Dr. Hill said.
• Guided injections: Can assist in accurately guiding injections for treatment.

When Should An Athlete Consider An MSK Ultrasound?

An athlete may receive an MSK ultrasound if they experience persistent pain, swelling or mobility issues in their joints or muscles. Musculoskeletal ultrasounds are also useful for evaluating specific injuries like tendon tears or ligament strains.

What Conditions Or Injuries Can MSK Ultrasounds Help Diagnose?

MSK ultrasounds can help diagnose a large variety of conditions.

"Usually, we're looking mostly for muscle tears, sprains to ligaments, and we're even able to evaluate the nerves," Dr. Hill said. "Ultrasound tends to be one of the best tools to visualize nerves for people dealing with like carpal tunnel syndrome, and it's even better when you than using MRI in regards to peripheral nerve evaluation."

How Does MSK Ultrasound Compare To Other Imaging Tests?

Each type of imaging test has its benefits. MSK ultrasound is particularly useful for dynamic assessment and guided procedures.

X-ray vs. MSK ultrasound

"With an X-ray, the primary purpose, especially in Sports Medicine, is to rule out fractures or any underlying arthritis," Dr. Hills said. "With an ultrasound, our goal is more to visualize the soft tissue structures overlying those bones, which can include muscles, tendons or ligaments."

Dr. Hills compares the uses of musculoskeletal ultrasound to X-ray like seeing a single tree in a forest.

"With an X-ray, you're looking at a forest from the top of the forest as a whole there," he said. "But then, with an ultrasound, you're getting down to more of the details and looking at one specific tree is kind of how I like to provide a reference for patients."

MRI vs. MSK ultrasound

"The nice thing with an ultrasound versus an MRI, we're also visualizing those same soft-tissue structures, but we're able to make it a little bit more dynamic," Dr. Hills said. "I can make an athlete move their arm or move that muscle as I'm imaging it, which is something that's very unique to ultrasound that you can't do with an MRI scanner."

Dr. Hills explains other benefits of musculoskeletal ultrasound over an MRI.

"So if someone's claustrophobic, and they can't tolerate an MRI, ultrasound becomes a great tool for them," he said. "Or if someone has had a prior surgery and there's hardware in that area, unfortunately, that hardware can cause artifacts or distortions in the images when you get an MRI. So, an ultrasound is another tool around that."

Where Can Athletes Get MSK Ultrasound?

Athletes should consult their healthcare provider for a referral to a Franciscan facility that specializes in sports-related injuries.

"The use is definitely determined by a physician, similar to an x-ray or an MRI," Dr. Hills said. "Unfortunately, a physician does have to place an order for that imaging study to be done. But it's definitely something that a patient can bring up."

If you're an athlete experiencing musculoskeletal issues, consider discussing MSK ultrasound with your healthcare provider to explore how it can aid in diagnosis and treatment.