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Introduction ⬇

A musculoskeletal ultrasound is a noninvasive imaging study that is performed to evaluate muscles, tendons, ligaments, nerves, and joints. It can be performed to identify tendon tears or tendinitis throughout the body, masses or fluid collections, muscle of ligament sprains or tears, inflammation or effusions within the bursae and joints, nerve entrapments, soft tissue tumors, or foreign bodies.

Procedure ⬆ ⬇

  1. Position the patient according to the area that requires examination (sitting in a chair or on examination table, lying face up or face down on an examination table).

  2. Apply a couplant (ultrasound gel) to the area. Move the transducer across the skin’s surface.

  3. Tell the patient that the examination time is about 15–30 minutes.

  4. See Chapter 1 guidelines for intratest care.

Clinical Implications ⬆ ⬇

Findings may help identify:

  1. Malignant or benign soft tissue tumor

  2. Ligament or muscle tear or sprain

  3. Muscle mass or fluid collection

  4. Foreign body in soft tissue, such as glass

  5. Fluid effusions or inflammation

  6. Early changes in rheumatoid arthritis

  7. Hernias

  8. Ganglion cysts along the joint or tendons of hands or wrists

  9. Hip dislocation in infants

Interventions ⬆ ⬇

Pretest Patient Care

  1. Explain the purpose and procedure of the test.

  2. Assure the patient that there is no pain involved; however, it may be uncomfortable maintaining the requested position during the examination.

  3. Explain that a liberal coating of coupling agent must be applied to the skin so that there is no air between the skin and the transducer and to allow for easy movement of the transducer over the skin. A sensation of warmth or wetness may be felt.

  4. Advise the patient to remove clothing and jewelry from the testing area.

  5. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care

  1. Review test results; report and record findings. Modify the nursing care plan as needed.

  2. Counsel about follow-up testing or treatment based on findings or abnormalities.

  3. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.

Interfering Factors ⬆ ⬇

  1. Ultrasound can only examine the outer surface of bones; therefore, injury that involves bones may require additional testing.

  2. Deeper structures may not be easily identified.

  3. Ultrasound does not detect whiplash or other back injury.

Reference Values ⬆

Normal