Musculoskeletal ultrasound imaging: diagnostic and treatment aid in rehabilitation

Ultrasound imaging of the musculoskeletal system has been used for almost 30 years. This paper reviews the history and various applications of musculoskeletal ultrasound imaging, concentrating on those aspects pertinent to rehabilitation. The type of imaging described is real-time B-mode ultrasound. The importance of technical considerations in the use of ultrasound imaging is highlighted, and some practical guidance on the scanning procedure is given. The main areas of application are diagnosis of tissue damage to structures such as tendons, muscle, ligaments, bursae, etc; measurement of muscle size for assessing atrophy; and a potential use is characterization of muscle shape for assessing tone. Ultrasound can be used to monitor treatment effectiveness as well as provide visual feedback during treatment to aid muscle contraction and relaxation. The clinical areas where ultrasound has been used include sports medicine and orthopaedics, rheumatology, neurology, paediatrics and respiratory physiotherapy. The potential uses of ultrasound imaging are underexplored and further normal data are required. The main area of interest to physiotherapists identified to date is examination of muscle dimensions (size and shape) for assessing the effects of pathology on muscle dysfunction and for monitoring the effects of treatments.