Ultrasound imaging in the hands of physical therapists: unlocking potential across specialties

Access to the clinical use of ultrasound imaging by physical therapists (e.g., costs, portability, and educational resources) has improved significantly over the last 5–10 years, while the clinical applications for ultrasound imaging continue to expand. Along with this rapid growth, substantial evidence has been developed regarding the clinical utility and diagnostic value of ultrasound imaging in physical therapy practice, particularly in orthopedic, cardiovascular, lung, pediatric, and pelvic health physical therapy. This narrative review aims to demonstrate how ultrasound imaging can be applied as a practical, evidence-supported clinical tool in physical therapy practice, by presenting a sample of the type and strength of evidence for its applications in evaluating injuries or pathologies of bone, ligament, tendon, muscle, nerve, heart, vascular, lung, diaphragm, and pelvic structures. When integrated with the physical therapist's clinical examination, ultrasound imaging will provide objective information that enhances clinical reasoning, supports decision-making, and directly informs patient management, leading to improved care delivery, efficiency, and outcomes. To promote the effective and responsible use of ultrasound imaging across practice areas, appropriate education and training are required. Educational models, strategies, curricular recommendations, and documented outcomes in professional programs are discussed to support the translation of ultrasound imaging into routine physical therapy clinical practice.