Ultrasound: Basic understanding and learning the language

Abstract

Ultrasound (US) use has rapidly entered the field of acute pain medicine and regional anesthesia and interventional pain medicine over the last decade, and it may even become the standard of practice. The advantages of US guidance over conventional techniques include the ability to both view the targeted structure and visualize, in real time, the distribution of the injected medication, and the capacity to control its distribution by readjusting the needle position, if needed. US guidance should plausibly improve the success rate of the procedures, their safety and speed. This article provides basic information on musculoskeletal US techniques, with an emphasis on the principles and practical aspects. We stress that for the best use of US, one should venture beyond the “pattern recognition” mode to the more advanced systematic approach and use US as a tool to visualize structures beyond the skin (sonoanatomy mode). We discuss the sonographic appearance of different tissues, introduce the reader to commonly used US-related terminology, cover basic machine “knobology” and fundamentals of US probe selection and manipulation. At the end, we discuss US-guided needle advancement. We only briefly touch on topics dealing with physics, artifacts, or sonopathology, which are available elsewhere in the medical literature.

Fortetropin inhibits disuse muscle atrophy in dogs after tibial plateau leveling osteotomy

“…This variation was attributed to various degrees of force applied by the different examiners on the muscle mass being evaluated. In the absence of a force transducer, this could not be standardized for each measurement and excessive pressure placed on the muscle through the probe likely resulted in tissue distortion and an underestimation of depth during image acquisition [20].…”

“…In this study we did not randomize for breed-matched cases or hair coat thickness and hair thickness has previously been reported to affect thigh circumference measurements in dogs [21]. Since baseline measurements were taken prior to aseptic preparation of the affected limb for completion of the TPLO, variable rates of hair regrowth following surgery could result in perceived changes when using a spring tension measuring device [20]. However, given that thigh circumference measurements were taken by one of two individuals, we felt these measurements were more consistent and reliable throughout the study than ultrasonographic measurements of muscle thickness.…”

An overview of point-of-care ultrasound for soft tissue and musculoskeletal applications in the emergency department

“…To optimize images, it is crucial to adjust gain, frequency, and focal zones [ 5 ]. Comparison to the contralateral part in a dual image is important to differentiate normal from abnormal structures.…”

Multi-Modal Imaging to Assess the Interaction Between Inflammation and Bone Damage Progression in Inflammatory Arthritis

“…In contrast to HR-pQCT's excellent spatial resolution of bone, ultrasound and magnetic resonance imaging (MRI) have superior contrast and resolution of soft tissue and can detect features of inflammation. While ultrasound can acquire multiplanar images and facilitate the identification and grading of superficial bony features (10,11), this imaging technique is limited in its application for analysis below the cortical surface and only provides images several centimeters below the probe (12). However, the presence of a power doppler signal identifies sites of active synovial inflammation without exogenous contrast enhancement.…”