his book is a quick start guide that equips students and professionals with musculoskeletal ultrasound image acquisition basics. Written in plain language, it focuses on the common, clinically relevant conditions diagnosable by musculoskeletal ultrasound. With many verbal and illustrative mnemonics, images, and whimsical illustrations, the manual provides many different methods to remember complicated anatomy and examination protocols.
Manual of Musculoskeletal Ultrasound teaches a protocol-based approach designed to help people understand why and how we perform musculoskeletal ultrasound studies. Each chapter covers a different body part and starts with basic anatomy and the clinical questions we want an ultrasound examination of that body part to answer. The protocols within each chapter tell the student precisely how and where to move the probe to obtain and optimize images. It demonstrates what a normal sonographic image should look like and explains what dynamic or structural issues would be abnormal in certain clinical circumstances. The protocol is a checklist that can be practiced on a partner or the reader themself. Chapters also discuss pathologic entities discernable on ultrasound, pitfalls to avoid, and imaging tricks of the trade.
This manual is invaluable for students and practicing clinicians in rheumatology, orthopedics, physiatry, neurology, sports medicine, advanced practice, and sonography.
Manual of Musculoskeletal Ultrasound teaches a protocol-based approach designed to help people understand why and how we perform musculoskeletal ultrasound studies. Each chapter covers a different body part and starts with basic anatomy and the clinical questions we want an ultrasound examination of that body part to answer. The protocols within each chapter tell the student precisely how and where to move the probe to obtain and optimize images. It demonstrates what a normal sonographic image should look like and explains what dynamic or structural issues would be abnormal in certain clinical circumstances. The protocol is a checklist that can be practiced on a partner or the reader themself. Chapters also discuss pathologic entities discernable on ultrasound, pitfalls to avoid, and imaging tricks of the trade.
This manual is invaluable for students and practicing clinicians in rheumatology, orthopedics, physiatry, neurology, sports medicine, advanced practice, and sonography.
--This text refers to the hardcover edition.Contents
1 Introduction/Getting Started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 1 |
Why Learn Musculoskeletal Ultrasound?. . . . . . . . . . . . . . . . . . . . . . . . | 1 |
Why a Protocol-Driven Approach?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 1 |
The Goals of This Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 2 |
Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 2 |
Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 6 |
Tissues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 9 |
Sonographic Pathology by Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . | 15 |
Artifacts: Friend or Foe? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 19 |
Organization of the Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 21 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 23 |
2 Volar Wrist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 27 |
Basic Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 27 |
Clinical Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 29 |
Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 31 |
Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 32 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 42 |
3 Dorsal Wrist (Radial, Dorsal, Ulnar) . . . . . . . . . . . . . . . . . . . . . . . . . . | 45 |
Necessary Basic Anatomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 46 |
Clinical Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 50 |
Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 55 |
Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 56 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 73 |
4 Fingers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 77 |
Necessary Basic Anatomy (Fig. 4.1). . . . . . . . . . . . . . . . . . . . . . . . . . . . | 78 |
Clinical Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 82 |
Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 92 |
Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 93 |
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 106 |
xii Contents
Hand Arthropathies 109
Necessary Anatomy 109
Clinical Comments 110
Pitfalls 128
Method 130
References 139
Anterior Elbow 147
Anatomy 147
Clinical Comments 151
Pitfalls 155
Method 155
References 165
Posterior Elbow 167
Anatomy 167
Clinical Comments 168
Pitfalls 170
Method 171
References 176
Lateral Elbow 177
Anatomy 177
Clinical Comments 180
Pitfalls 182
Method 182
References 188
Medial Elbow 189
Basic Anatomy 190
Clinical Comments 192
Pitfalls 194
Method 195
References 204
Shoulder 207
Basic Anatomy 207
Clinical Comments 211
Pitfalls 227
Method 228
References 248
Anterior Ankle 255
Basic Anatomy (Fig. 11.1) 255
Clinical Comments 258
Pitfalls 267
Method 267
References 275
Contents xiii
Posterior Ankle and Heel 279
Bony Anatomy 280
Clinical Comments 283
Pitfalls 288
Method 289
References 295
Lateral Ankle 299
Basic Anatomy 299
Clinical Comments 303
Pitfalls 309
Method 310
References 319
Medial Ankle 323
Basic Bone Anatomy (Fig. 14.1) 323
Clinical Comments 328
Pitfalls 332
Method 333
References 343
Forefoot and Toes 347
Basic Anatomy 347
Clinical Comments 349
Pitfalls 360
Method 361
References 370
Anterior Knee 373
Basic Anatomy 374
Clinical Comments 377
Pitfalls 379
Method 380
References 388
Posterior Knee 391
Necessary Basic Anatomy: Posterior Knee 392
Clinical Comments 394
Ligament Damage 395
Nerve Damage 396
Blood Vessel Pathology 396
Fabella Pathology 396
Cartilage Damage 397
Meniscal Damage 397
Pitfalls 397
Method 397
References 407
xiv Contents
Lateral Knee 409
Basic Anatomy 410
Clinical Comments 411
Anterolateral Ligament 412
Lateral Collateral Ligament 412
Lateral Meniscus 413
Biceps Femoris Tendon 414
Common Peroneal Nerve 414
Pitfalls 414
Method 415
References 422
Medial Knee 425
Basic Anatomy (Fig. 19.1) 426
Pes Anserine Tendons and Bursa 426
Clinical Comments 428
Medial Collateral Ligament Bursitis 429
Medial Meniscus 429
Pes Anserine Tendons and Bursitis 430
Snapping Pes Anserine Tendons 430
Infrapatellar Branch of the Saphenous Nerve Damage 431
Pitfalls 431
Method 432
References 436
Anterior Hip 439
Basic Anatomy 439
Ligaments 441
Neurovascular Bundle 442
Anterior Hip (Joint) Recess 442
Hip Joint 443
Iliopsoas Muscle, Tendon, and Bursa 443
Tensor Fascia Lata and Sartorius 443
Rectus Femoris 443
Clinical Comments 443
Joint Effusion and Synovitis 444
Iliopsoas Bursitis 444
Labrum Abnormalities 445
Postsurgical Hip 445
Tendon and Muscle Abnormalities 446
Snapping Hip Syndrome 446
Calcific Tendinosis 447
Diabetic Muscle Infarction 447
Meralgia Paresthetica 448
Contents xv
Inguinal Lymph Nodes 448
Pitfalls 449
Method 449
References 459
Posterior Hip 461
Anatomy 461
Clinical Comments 464
Piriformis Syndrome 465
Ischiogluteal Bursitis 465
Pitfalls 465
Method 466
References 472
Lateral Hip 473
Basic Anatomy 473
Clinical Comments 476
Tendinosis and Tendon Tears 478
Snapping Iliotibial Band and External Lateral Snapping
Hip Syndrome 478
Morel-Lavallee Lesion 479
Tensor Fascia Latae Tendinopathy 479
Bursal Abnormalities 480
Proximal Iliotibial Band Syndrome 480
Pitfalls 480
Method 481
References 486
Medial Hip 489
Basic Anatomy 489
Clinical Comments 491
Tendinosis and Partial-Thickness Tears 491
Muscle Strain 492
Adductor Insertion Avulsion Syndrome 492
Other Sources of Pain 492
Method 492
References 496
Crystalline Disease 497
Clinical Comments 498
Gout 498
Calcium Pyrophosphate Deposition Disease 500
Sonographic Overlap 501
Pitfalls 502
Method 502
References 510
xvi Contents
Enthesopathy 513
Clinical Comments 513
Special Clinical Consideration: Inflammatory Arthritis
Differentiation 517
Pitfalls 517
Method 518
References 529
Index 533
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