Musculoskeletal Ultrasound
risk factors for WRMSDs
-forceful exertion: pushing/pulling, lifting, gripping, and pinching -repetition -awkward -contact pressure: sustained contact between a body part and an external object
what is the treatment of muscle hematoma?
-heating pads, heat lamps, ointments, whirlpools, and compresses, ibruprofen
what are fibers?
-long and organized -run parallel to the bones -voluntarily controlled -move muscle and joint -separates muscles -nerves, blood vessels, and lymphatics follow the fibrous partitions
what is the treatment of Baker's cyst?
-may not need any -tend to go away on their own -apply cold pack for swelling -ibuprofen -rest above heart level
What am I? -tennis elbow, or lateral epicondylitis, condition in which forearm muscles become damage from overuse -characterized by pain from elbow to the wrist on medial side of elbow. -pain is caused by damage to tendons that bend the wrist toward the palm
epicondylitis
What am I? -inflammation of fascia -pain at bottom of heel - the plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness
fasciitis
muscle contains....
fibers
What is the treatment to fasciitis?
ibuprofen, physical therapy, night splints, orthotics, injections
Cardiac and smooth muscle is _____ where skeletal muscle is ____
involuntary, voluntary
What am I? - a benign tumor made of fat tissue -most common benign soft tissue tumor -generally soft to the touch, movable, and painless -usually occur just under the skin, but occasionally may be deeper -most are less than 5 cm in size -common locations include upper back, shoulders, and abdomen
lipoma
Muscle is connected to the skeleton to form part of the ____system which moves the limbs and other parts of the body
mechanical
What am I? -inflammation of any of the tendons supporting muscles -affects movements of the joint -severe swelling of a tendon -happens after repeated injury to an area such as the wrist or ankle -causes pain and soreness around a joint -named after the sports that increase their risk
tendonitis
What am I? -a condition whereby pain and stiffness occur in the neck -tendernes in the trapezius muscle -headache and fatigue -most common causes are arthritis or an overuse injury -strains involving trauma to muscles and tendons or sprains caused by pulled or stretched ligaments that attach bone to bone
tension neck syndrome
What am I? -a group of conditions that develop when the vessels or nerves in the thoracic outlet become compressed -can cause pain in shoulders and neck and numbness in fingers -common causes include physical trauma, repetitive injuries, certain anatomical defects, and pregnancy -treatment involves physical therapy and pain relief measures
thoracic outlet syndrome
Tendon
-a collection of collagenous fibers that stretches and flex around structures. -attaches muscle to bone -attaches proximal and distal muscles parts -no blood supply -heals slow -can/can't have synovial sheath
what is the treatment of muscle strain?
-apply ice pack and maintain muscle in a stretched position -heat when swelling has lessened -nonsteroidal anti-inflammatory drugs (NSAIDS) to reduce pain
ligaments
-bone to bone -short bands of fiber -support and strengthen joint -important in knees, ankles, and shoulders
what is the most commonly performed surgical procedure for surgical disc prolapse?
-cervical foraminotomy with excision of disc prolapse -anterior cervical discectomy with fusion
nerves
-conduits for impulses to and from the muscles and CNS -Elements of nerves include nerve fibers and shears of myelin -nerve fibers are arranged into bundles called fasciculi
what is the sonographic appearance of nerves?
-more hypoechoic compared with muscle -hypoechoic compared to tendons -in long plane, it has fibrillary pattern with parallel inner linear echoes similar to tendon -in trans, the nerve fibers appear hypoechoic perineurium surrounding each fiber -in outer layer, epineurium is hyperechoic layer
what is the treatment for tension neck syndrome?
-neck and shoulder stretch -chest and shoulder stretch -eagle arms
What are symptoms to disc prolapse?
-numbness, tingling, pins in extremities -pain in butt or underneath shoulder blades -pain radiating down extremities -sciatica in pain cause by pinched nerve in lower back -weakness in extremities -in severe cases, bowel or bladder control, numbness in genital area, and potence
what is the sonographic appearance of muscle?
-prox part is the origin, distal end is the insertion -muscle fibers are hypoechoic -connective tissue surrounding the fiber bundles produce echogenic lines -fascia is hyperechoic than fibers, but less than subcutaneous fat and tendon
bursa
-saclike structure -facilitate the movement of tendons or muscles over bony projections -surrounds joints and tendons that contains a viscous fluid -provides area of synovial fluid to aid in reduction of friction btw 2 structures -knee has 9 bursae
what is the sonographic appearance of bursa?
-small sac btw two moving surfaces, usually tendon and bone -fluid filled cavity -Baker's cyst is communicating -prepatellar bursa is superficial, noncommunicating bursa -over 2 mm is enlarged
what is the sonographic appearance of ligament?
-superficial structure -hyperechoic strap-like structures -longitudinal is the only method used to image injuries
what are the symptoms of muscle strain?
-swelling, bruising, redness -pain at rest -pain when the specific muscle or joint in relation to that muscle is used -weakness of the muscle or tendons -inability to us muscle at all
What are the risk factors to disc prolapse?
-trauma that causes vertebra to fracture -job that requires lots of lifting -job that requires a lot of sitting -weight-bearing sports or exercise -obesity -smoking -weakness in the spine due to normal aging
synovial sheath
-tubular sac surrounding the tendon -2 layers with fluid in between -achilles and patellar tendons lack this sheath -found in shoulder, hand, wrist, ankle
what is the sonographic appearance of tendon?
-with and within synovial sheath -normal sheath is hypoechoic halo surrounding tendon -should measure up to 2 mm -acute disease may reveal a sheath that is thicker than contained tendon -hand, wrist, and ankle contain tendon with sheath -abnormal bursa enhances the tendon -achilles, patellar, and prox gastrocnemius and semimembranosus tendon lack sheath
What am I? -popliteal cyst -a fluid-filled swelling that causes a lump at the back of the knee -leads to tightness and restricted movement -painful when bending or extension of knee -usually due to a problem that affects knee joint, such as arthritis or a cartilage injury
Baker's cyst
What am I? -a fluid filled lump associated with a joint or tendon sheath -most often occur at the back of the wrist followed by the front of the wrist -may occur in ankles, feet -an be painful if they press on a nearby nerve -can interfere with joint movement
Ganglion cyst
What am I? -a tender mass generally surrounded by a colored area from pink to deep red -caused by infection -full of pus, bacteria and debris
abscess
What am I? - an injury that happens to the largest tendon in the human body -fibrous tissue that connects the two large muscles in the back of your calf with your heel bone -these muscles (the gastrocnemius and the soleus) create the power needed to push off with your foot or rise up on your toes
achilles tendon injury
What am I? -One of the most common forms of injuries encountered by athletes -occurs when one of the four main ligaments in the knee, called ACL tears -knee becomes less stable
anterior cruciate ligament injury (ACL)
what is the treatment for an abscess
antibiotics, drainage procedure, surgery
What is a collection of symptoms and signs that occurs following entrapment of the median nerve within the carpal tunnel?
carpal tunnel syndrome
What am I? -a bacterial infection involving the inner layers of the skin -affects the dermis and subcutaneous fat -sign and symptoms include area of redness which increases in size over few days -borders are red and skin may be swollen -infection is usually painful -sometimes it appears in areas where skin has broken open, such as the skin near ulcers or surgical incision
cellulitis
What am I? -a nerve issue that results in pain and tingling in hand and fingers -part of the aging process
digital neuritis
What am I? -may also be called a herniated slipped, or ruptured disc -hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall -occurs when the nucleus pulposus herniates through the outer layer of the disc -the prolapsed disc then puts pressure on other structures in the spinal column, most notable, the spinal nerves
disc prolapse
What am I? -localized collection of blood outside the blood vessels -due to either disease or trauma -may involve blood continuing to seep from broken capillaries -initially in liquid form spread among the tissues including in sacs btw tissues where it may coagulate and solidify before blood is reabsorbed into blood vessels
muscle hematoma
What am I? -a streptococcal infection beginning with severe or extensive cellulitis that spreads to involve the superficial and deep fascia -producing thrombosis of the subcutaneous vessels and gangrene of the underlying tissues
necrotizing fasciitis
Work related musculoskeletal disorders (WRMSDs) are ....
painful injuries affecting the muscles, nerves, ligaments, and tendons
What am I? -inflammation of an interdigital nerve at its division -characterized by sharp or dull pain and/or paraesthesia of plantar webbing area and associated toes -predisposes to plantar digital neuroma
plantar digital neuritis
What am I? -caused by increased pressure, compression and entrapment of the radial nerve as it travels from the upper arm to the hand and wrist -radial nerve becomes irritated and/or inflamed from friction caused by compression by muscles in the forearm -from lateral elbow to wrist -increases during forearm rotation and lifting activities
radial tunnel syndrome
tendonitis is an inflammation of the _____ and/or _____
rotator cuff, biceps tendon
All joints, ligaments, and tendons have the ____ sonographic characteristics
same
What am I? -a cancer that start in soft tissues -can develop anywhere in the body but are found mostly in the arms, legs, chest, and abdomen
sarcoma
What am I? -cell growths that emerge nearly anywhere in th ebody -in tendons, muscles, ligaments, cartilage, nerves, blood vessels, fat, and other tissues - commonly referred to as lumps or bumps (?)
soft tissue tumors
a _____ is an injury to a ligament, while a _____ is an injury to muscle or tendon tissue.
sprain, strain