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