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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