Applications of musculoskeletal sonography

To successfully examine the musculoskeletal system sonographically, one must understand the normal musculoskeletal anatomy and function and be aware of the abnormal processes that affect the musculoskeletal structures. The goal of this review article is to provide a systematic approach to sonographic examination of the musculoskeletal system. The general sonographic appearances of normal and abnormal muscles, tendons, ligaments, bursae, and nerves are reviewed. The article then applies this general information to specific clinical applications by reviewing the normal anatomy of and specific pathologic conditions that affect the shoulder, elbow, hand, wrist, hip, knee, ankle, and foot.

Ultrasonographic stress testing of ulnar collateral ligament injuries of the thumb

We compared ultrasonographic stress test evaluation to clinical examination of ulnar collateral ligament injuries to the thumb. The results of the sonographic and clinical examinations were compared to either operative findings or clinical follow-up results if conservative treatment was elected. Of 25 patients, the clinical grade injury was identified correctly in 25 with ultrasonography compared to 24 with clinical examination. Of the grade III tears, ultrasonography missed two patients with Stener tears and physical examination misidentified or missed four patients with Stener tears. These results confirm the experience of others that ultrasonography is a useful method to evaluate injury to the ulnar collateral ligament of the thumb.