Ultrasound is an imaging method of medical investigation that uses ultrasounds to gather information from the human body.
Being very accessible, without major contraindications and without the risk of irradiation, ultrasound is increasingly being used and the information obtained is extremely useful, so nowadays ultrasound is often considered as an “extension of the hand” of the clinician. From the first applications in medicine, approximately in the middle of the last century, ultrasonography has experienced an explosive growth, today having an extended applicability in practically all specialties.
Soft tissue ultrasound, or musculoskeletal ultrasound, is the prerogative of rheumatology, orthopedics and medical rehabilitation, bringing information about joints, bursae, muscles, tendons, nerves, periosteum as well as lymph nodes, parotid glands, adipose tissue and various tumors.
Almost every joint in the human body has a standardized protocol for examination, and many rheumatic conditions such as osteoarthritis, rheumatoid arthritis, gout, rheumatoid arthritis, etc. have characteristic ultrasound elements, very important both in the accurate diagnosis of these diseases and in establishing their severity.
In the examination of the knee, the most complex joint, ultrasound reveals the normal anatomy and lesions of the menisci, collateral ligaments, patellar retinaculae, patellar and quadriceps tendons, as well as vascular and tendon elements of the posterior compartment. The thickness of the cartilage is easy to measure, and the fluid collections from the joint recesses and from the numerous bags lining the knee are excellently visualized. Thus, the diagnosis of gonarthrosis, meniscal degeneration, tendon and ligament ruptures, prepatellar bursitis and Baker / popliteal cyst, gout and chondrocalcinosis, as well as specific tendon disorders such as Osgood Schlatter’s disease and “Jumper’s Knee” is much easier.
In the examination of the shoulder, the rotator cuff tendons, the gleno-humeral joint and the acromioclavicular joint, as well as the subacromio-subdeltoid bursa are precisely evaluated due to the superficial subcutaneous position, which creates an optimal ultrasound window. Thus, tendinopathies of the rotator cuff, especially of the supraspinatus, sub-acromio-subdeltoid bursitis, osteoarthritis and acromioclavicular disjunction are diagnosed mainly by ultrasound.
Ultrasound of the hand is extremely useful in diagnosing rheumatoid arthritis, where the fence of synovial inflammation is staged ultrasound by various scores, the Power Doppler signal being a tool with great weight in the certification of synovitis. Bone erosions often found in this disease are accessible to ultrasound, being considered a marker of severity and being a decision-making node in the therapy of this common disease. Osteophytes specific to osteoarthritis of the hand have a characteristic ultrasound appearance and are easy to detect. The median nerve is easy to examine and ultrasound adds to the diagnosis of carpal tunnel syndrome.
Beyond assessing virtually all limb joints, ultrasound is very useful in diagnosing trauma; thus, contusions and muscle tears such as various post-traumatic collections of subcutaneous tissue (hematomas and seromas) are accessible to this method of investigation.
It is important to mention, the lymph nodes have well-defined ultrasound characteristics in the malignant / benign differentiation, very useful in the detection of various malignant tumors and lymphomas.
In recent years, ultrasound has greatly contributed to interventional medicine, intraarticular evacuation punctures as well as the storage of cortisone and intraarticular hyaluronic acid, the treatment of bursitis and tendonitis, and periarticular, peritendinous, perineural infiltrations have a very high degree of accuracy when are performed under ultrasound guidance.
Widely used and well known, this method of investigation deserves a leading place in modern imaging by providing accurate and reliable information on various lesions / pathologies, by relatively low costs, high availability, lack of ionizing radiation and applicability in outpatient and in bed. the patient.