Sonography provides a higher spatial resolution and the ability to explore long segments of muscle, tendon and nerve structures. No special preparation is required for these types of scan. At the examination you will need to remove clothing and jewellery from the area to be examined. Usually you will lie on your back on an examination couch, but for specialised areas you may be in different positions. The transducer will be moved back and forth across the relevant part of your body in order to image the area of interest. You may also be asked to move joints or limbs so that the sonography practitioner can examine the affected area with real-time scanning while it is in motion
Sonography of the musculoskeletal system provides pictures of muscles, tendons, ligaments, joints and other soft tissues throughout the body. This type of scanning is typically used to assist in the diagnosis of tendon inflammation, tears, such as of the rotator cuff in the shoulder and Achilles tendon in the ankle. Sonography is an excellent and validated tool in the assessment of inflammatory joint diseases. It can also be used as a guide for steroid injections into joints and surrounding soft tissues as an effective treatment for painful joints.
Soft Tissue Sonography is used to investigate a wide range of soft-tissue masses. This can detect a variety lesions ranging from the common lipomas, to calcifications, tophaceous gout or rheumatoid nodules, sebaceous cysts, haemangiomas, bleeding or other fluid collections within the muscles to the rare primary malignant (sarcoma) tumours and metastases.
Sonography can pinpoint the exact location of the lesion i.e. whether it lies beneath the skin or deep in the muscles, its size, characteristics such as solid, cystic, or mixed and the presence of blood flow. All very useful features in terms of treatment planning can be depicted sonographically.
However, sonography will not be able to determine if the tumour might have spread to other parts of the body. Often the patient will be referred to the surgeons who will then arrange further scans such as MR and CT to further assess and plan treatment appropriately.
Interventional sonography’ refers to a wide range of invasive procedures performed percutaneously (through the skin) using US guidance. No special preparation is required. You may be asked to wear a gown for the procedure.
In musculoskeletal practice, most of these procedures consist of aspiration of fluid collections and injection of steroids either into joint cavities, para-articular soft tissues or tendon sheaths. More complex US-guided procedures such as biopsies of space-occupying masses and removal of foreign bodies are usually performed in specialised tertiary centres. Harmonic Medical Sonography, we will soon be offering US-guided steroid injections.
The procedure will be discussed with you before the scan and you will be given specific advice about driving or operating machinery.