Nuts and bolts of MSK: the sonographer’s place in the toolbox
- Featuring
- March 17 2025
- Duration 1:4:19
What are the situations and musculoskeletal (MSK) cases that benefit from ultrasound? How are technological developments changing MSK ultrasound capabilities and changing sonographers’ ability to help identify disorders? Here, MSK ultrasound specialist John Persinger shares his expertise based on decades of experience as a diagnostic sonographer.
At-a-glance:
- [10:32] Opportunities for sonographers in MSK
- [18:42] Technical considerations: orientation and anisotropy
- [21:44] Differentiating MSK structures on ultrasound images
- [28:22] Applications of new technologies seen in MSK
- (26:56) – considerations for frequency are detail, penetration, resolution
Persinger describes the most common applications of MSK ultrasound: carpal tunnel, knee, median nerve, Achilles tendon and plantar fascia. He goes on to share other professional opportunities that have come up in his career as an MSK ultrasound specialist, such as training residents, fellows and other doctors ultrasound techniques; administrative support; assisting with procedures; and supporting specialty clinics, such as sports medicine.
Differentiating MSK structures on ultrasound images
Persinger walks through examples of sonoanatomy and shows how images look vastly different when using certain systems and transducers. He explains how he identifies bone, tendons, ligaments, bursae (any site for potential fluid accumulation), nerves and muscles.
Technical consideration & comparisons
Persinger shows cases he’s seen that could have benefitted from new ultrasound technology and system enhancements, including Philips AutoSCAN, Flow Viewer, the XL14-3 transducer and mL26-8 transducer. Comparisons of transducer views and images include:
- Patellar tendon
- Triceps tendon
- Achilles tendon
- Stump neuroma
- Sports hernia
- Supraspinatus tear
- Soft tissue
- Tibialis anterior
- Ulnar nerve
- De Quervain
- A2 pulley
- Flexor tendon
- Lister’s tubercle