Musculoskeletal ultrasound provides real-time imaging of many superficial tendons, ligaments, muscles, nerves, bursae and joints.
What can musculoskeletal ultrasound assess?
Musculoskeletal ultrasound is commonly used for shoulder, elbow, wrist, hand, hip, knee, ankle and foot symptoms. It can assess tendons, muscles, ligaments, superficial nerves, fluid collections, bursae and the outer surfaces of joints.
- Tendon thickening, degeneration, partial tears and some complete tears.
- Muscle injury, haematoma and scar tissue.
- Bursitis, joint fluid and synovial inflammation.
- Superficial nerve enlargement, compression or abnormal movement.
- Cysts, soft-tissue lumps and some foreign bodies.
- Blood flow associated with inflammation or healing.
Why dynamic assessment matters
Ultrasound is performed in real time. The sonographer can ask you to move the painful structure, reproduce a clicking or snapping sensation, or compare the symptomatic side with the other side. This can reveal abnormal tendon movement, impingement, instability or nerve subluxation that may not be visible when the body is still.
What happens during the examination?
No special preparation is usually required. Wear clothing that allows access to the affected area. The sonographer will ask where the pain occurs, scan the region in several positions and may apply pressure or ask you to move against resistance.
What are the limitations?
Ultrasound cannot see through bone and is less suitable for structures deep within some joints. It does not assess bone marrow, the internal structure of bone or every deep ligament and cartilage surface. MRI, X-ray or CT may be required when the suspected pathology lies beyond the ultrasound field or when a more complete anatomical map is needed.
Operator expertise, probe selection, patient anatomy and the ability to reproduce symptoms can affect the examination. A normal ultrasound does not exclude every cause of pain.
Ultrasound and image-guided treatment
Ultrasound can guide aspiration, biopsy and selected injections because the needle and target can be seen in real time. Diagnostic ultrasound and treatment planning should remain separate decisions: finding an abnormality does not automatically mean an injection is required.
Related Patient Guides
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- PG3004 Vascular and Doppler Ultrasound: Arteries, Veins and Blood Flow
- PG3005 Pelvic and Transvaginal Ultrasound: What to Expect
- PG3006 Breast and Axillary Ultrasound: Lumps, Symptoms and Follow-Up
- PG3007 Thyroid and Neck Ultrasound: Nodules, Lymph Nodes and Biopsy
- PG3008 Paediatric Ultrasound: A Guide for Parents and Carers
- PG3009 Contrast-Enhanced Ultrasound and Elastography: Advanced Ultrasound Explained
- PG3010 What Ultrasound Can and Cannot Show: When MRI, CT or Other Tests May Be Needed
We have more detailed information on many interesting regenerative and radiological topics on our Insights page
Frequently Asked Questions
For other FAQs please visit our FAQs page
Is ultrasound better than MRI for tendon injuries?
Neither is universally better. Ultrasound offers high-resolution dynamic imaging of many superficial tendons, while MRI provides a wider field of view and can assess bone marrow and deeper structures. The best test depends on the question.
Can ultrasound show a trapped nerve?
It can assess many superficial nerves for enlargement, compression, scarring or abnormal movement. Deep nerves and complex anatomical regions may require MR neurography or another examination.
Can the scan reproduce my pain?
The sonographer may use movement or gentle pressure to identify the structure associated with symptoms. Tell them if a manoeuvre causes significant pain.
| Important: Musculoskeletal pain can have more than one source. Ultrasound findings must be interpreted with the clinical examination and, when needed, other imaging. |
PATIENT GUIDE • PG-3003 [Patient information: Musculoskeletal ultrasound provides real-time imaging of many superficial tendons, ligaments, muscles, nerves, bursae and joints.]
