Diagnostic ultrasound is not just for pregnancy and gallbladders. For decades ultrasound has been used to diagnose joint, tendon, ligament and nerve problems in Europe, often used in place of MRI scans. It became more popular for diagnostics in the U.S. in the last 20 years but is still used infrequently. Although the main disadvantage compared to MRI is that the ultrasound beam does not penetrate bone, making it difficult to see tears of the inner knee meniscus and cruciate ligaments most musculoskeletal problems are not hidden behind bone. Ultrasound is routinely used to diagnose sprains and strains, rotator cuff problems in shoulder, ankle and foot pain including plantar fasciitis and Achilles tendon problems. Elbow problems including tennis and golfer’s elbow, and ulnar nerve entrapment are easily evaluated with ultrasound as are hand problems such as trigger finger, carpal tunnel, and other tendon and joint problems.
Ultrasound does not require laying still in a claustrophobic tunnel. It is much less expensive than MRI and in most cases the patient can be shown the images during the scan. Structures can be studies with motions often revealing tears or other pathology not well seen with X-rays and MRI. Nerve problems in the extremities are studies comfortably without electric shocks or needles.
Unlike MRI and Xray technicians, ultrasound requires extensive knowledge of the pertinent anatomy and takes much direct practice to become proficient. Many certified musculoskeletal sonographers are physicians doing studies on their own patients. Certification is designated by the initials R.M.S.K. behind the name in addition to M.D. or other degrees.