2018 Orthobiologics Surgical Skills Online-3 - Sonographic of MSK Structure by Douglas Hoffman, MD

Video Transcription

Video Summary

In this video, the speaker provides an overview of different structures seen on ultrasound imaging, such as bones, tendons, ligaments, muscles, and nerves, and describes their characteristics. The speaker discusses how ultrasound can be used as a roadmap for joint injections, highlighting the importance of bone in understanding the location of injections. They explain that tendons are hyperechoic with a fibular echo texture, allowing for clear visualization of individual collagen bundles. Ligaments, while similar, have a more compact fibular echo texture. Muscle, on the other hand, is hypoechoic in relation to bone, tendon, and ligament due to its higher water content. The speaker also emphasizes the improved resolution of nerves on ultrasound compared to MRIs, which has led to an increase in ultrasound-guided procedures involving nerves. They also touch on anisotropy as an artifact in ultrasound imaging and its impact on tendon visibility. The speaker then provides guidance on optimizing ultrasound images, including probe selection, adjusting depth, focal zone, and gain settings. They also discuss Doppler imaging, which detects vascular flow, and the importance of annotation to document and label images. Finally, the speaker highlights the benefits of ultrasound-guided injections over landmark-guided injections, citing evidence of improved accuracy and outcomes. They discuss the principles of ultrasound-guided injections, including ergonomic considerations, proper handling of the probe, and the use of a standoff to adjust injection angles if needed.

Keywords

ultrasound imaging

joint injections

tendon characteristics

nerve resolution

ultrasound-guided injections