Ultrasound Guided MSK Procedures
Ward McCracken, D.O.
Disclosures
• I have no disclosures
Workshop Break Down
• 20 minutes - Introduction
• 30 minutes - Scan
– Knee (IA, tendon guidance, Baker Cyst)
– Foot / Ankle (Achilles)
– Shoulder (Gleno-humeral)
• Other scans (if time - hip, hand, etc.)
• 5-10 minutes - questions
Introduction
• Normal Tissues
• Scanning Artifacts
• Common Procedures
Terminology
• “Echoic”
– Hyper-echoic (brighter)
– Hypo-echoic (darker)
– An-echoic (black)
• Axis
– Long vs Short Axis
Normal Tissues
Tendon• Achilles
Muscle
• Biceps Brachiii
Nerve (vs Tendon)
• Median Nerve
(arrow heads)
• Flexor carpi
radialis (open
arrow)
Ligament
Artifacts
• Anisotropy
Anisotropy
Artifacts
• Anisotropy
Artifacts
• Anisotropy
Artifacts
• Shadowing
?
Common Procedures
Hip - Intra-articular Injection
Common Indications:
• Osteoarthritis
• FAI
Hip - Intra-articular Injection
Anatomy
Hip - Intra-articular Injection
• Intra-articular Hip
Joint CapsuleNeedle
Medication
Femoral
Head
Knee - Injections / Aspirations
• Baker’s Cyst
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Baker’s Cyst?
Baker’s Cyst?
Knee – Intra-articular Injection / Aspiration
Patellar Tendon
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Achilles Tendon
• Ruptured Achilles
Achilles
• Ruptured Achilles – Plantar Flexion Gap
Glenohumeral Injection
References
• Jacobson, Jon. Fundamentals of Musculoskeletal Ultrasound,
3E. Elsevier: 2017.
• Malanga G, Mautner K. Atlas of Ultrasound Guided
Musculoskeletal Injections. McGraw-Hill Education / Medical:
2014.
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