
==== Front
Int J Sports Phys Ther
Int J Sports Phys Ther
2159
International Journal of Sports Physical Therapy
2159-2896
NASMI Website: International Journal of Sports Physical Therapy

36793580
68139
10.26603/001c.68139
Editorial
EDITORIAL: MSK Ultrasound and Introduction of IJSPT Ultrasound Bites Feature
Manske Robert C PT, DPT, SCS, ATC, CSCS 1
Page Phil PT, PhD, ATC, CSCS, FACSM 2
Voight Michael PT, DHSc, SCS, OCS, ATC, CSCS, FAPTA 3
Wolfe Chris PT, DPT, OCS, Cert MDT 3
1 Doctor of Physical Therapy Program Wichita State University https://ror.org/00c4e7y75
2 Doctor of Physical Therapy Program Franciscan University
3 School of Physical Therapy Belmont University https://ror.org/033vjpd42
Corresponding author: Robert.Manske@wichita.edu
2 2 2023
2023
18 1 68139© The Author(s)
https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (4.0) which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

msk ultrasound
rehabilitation ultrasound imaging
point of care ultrasound imaging
==== Body
pmcPoint of care ultrasound (POCUS), musculoskeletal ultrasound (MSK-US), and rehabilitation ultrasound imaging (RUSI) are similar procedures that use a non-ionizing imaging and is becoming more inexpensive, portable, safe, and able to be used quickly.1–4 These modalities are commonly used in various medical disciplines to assess musculoskeletal tissues (bones, muscles, tendons, ligaments, nerves) as well as structures such as the heart, lungs, and bladder just to name a few. MSK-US primarily focuses on the structural integrity or characteristics of the neuromuscular system. This would include viewing soft tissues for assessment of normalcy or abnormality. For example, viewing the supraspinatus for signs of swelling or a rotator cuff tear, or assessing the median nerve to measure swelling or size differences in those with carpal tunnel syndrome are commonly performed using MSK-US. RUSI is similar but includes the evaluation of muscle and soft tissue during exercise or movement dynamically including its use for biofeedback.5,6 An example of RUSI include real-time observation of spinal muscle (lumbar multifidus and transverse abdominus) activation patterns during exercise to facilitate improved neuromotor control.6

The use of MSK-US in clinical practice has nearly quadrupled since the early 2000’s, mainly due to its use with non-radiologists.3,7,8 Its surge in popularity parallels research suggesting that MSK-US is accurate and cost effective, with patients reporting greater satisfaction with MSK-US compared to magnetic resonance imaging (MRI).9–11

Introducing Ultrasound Bites

Ultrasound is becoming more widely recognized in rehabilitation as a valuable tool to objectively assess musculoskeletal structures and guide rehabilitation.6,12 The appropriate use of imaging is essential in all healthcare professions for accurate patient diagnosis and management as well as optimizing the use of healthcare resources.13 It should also be stressed that mistakes made by inadequately trained operators could jeopardize a patients’ wellbeing by delaying treatment for life threatening conditions.14 Because of this, the International Journal of Sports Physical Therapy (IJSPT) thought it important to educate readership with common tips to view various musculoskeletal structures. Starting with the long head of biceps tendon in our last issue,15 subsequent issues of IJSPT will include a section entitled “MSK Ultrasound Bites: Tips and Tricks”. Each month, a new structure that can be assessed with MSK-US will be thoroughly described, including normal and pathological structure findings with clear and concise guidelines describing probe placement and findings. As can be seen in a corresponding study in this issue, many therapists are utilizing MSK-US clinically.16 In addition, our clinical commentary this month provides an overview and introduction to the clinical use of MSK-US for rehabilitation, diagnosis, interventions and research. We believe that its use will continue to evolve as physical therapists become more adept at using this skill to propagate care beyond the traditional examination.16
==== Refs
Guidelines for musculoskeletal ultrasound in rheumatology Annals of the Rheumatic Diseases Backhaus M Burmester G Gerber T Grassi W Machold K Swen W 1 7 2001
60 7 641 649 0003-4967 10.1136/ard.60.7.641 10.1136/ard.60.7.641 11406516
Musculoskeletal ultrasound and MRI: Which do I choose? Seminars in Musculoskeletal Radiology Jacobson Jon A Georg Thieme Verlag KG New York 5 2005
9 02 135 149 1089-7860 10.1055/s-2005-872339 10.1055/s-2005-872339 16044382
Clinical indications for musculoskeletal ultrasound: A Delphi-Based consensus paper of the European Society of Musculoskeletal Radiology European Radiology Klauser Andrea S. Tagliafico Alberto Allen Gina M. Boutry Natalie Campbell Rob Court-Payen Michel Grainger Andrew Guerini Henry McNally Eugene O’Connor Philip J. Ostlere Simon Petroons Philippe Reijnierse Monique Sconfienza Luca Maria Silvestri Enzo Wilson David J. Martinoli Carlo Springer Science and Business Media LLC 28 3 2012
22 5 1140 1148 0938-7994 10.1007/s00330-011-2356-3 10.1007/s00330-011-2356-3
The top 10 reasons musculoskeletal sonography is an important complementary or alternative technique to MRI American Journal of Roentgenology Nazarian Levon N. 6 2008
190 6 1621 1626 0361-803X 10.2214/ajr.07.3385 10.2214/ajr.07.3385 18492916
Rehabilitative ultrasound imaging is a valid measure of trunk muscle size and activation during most isometric sub-maximal contractions: A systematic review Australian Journal of Physiotherapy Koppenhaver Shane L. Hebert Jeffrey J. Parent Eric C. Fritz Julie M. 2009
55 3 153 169 0004-9514 10.1016/s0004-9514(09)70076-5 10.1016/s0004-9514(09)70076-5 19681737
Rehabilitative ultrasound imaging: understanding the technology and its applications Journal of Orthopaedic & Sports Physical Therapy Whittaker Jackie L. Teyhen Deydre S. Elliott James M. Cook Katy Langevin Helene M. Dahl Haldis H. Stokes Maria Journal of Orthopaedic & Sports Physical Therapy (JOSPT) 8 2007
37 8 434 449 0190-6011 10.2519/jospt.2007.2350 10.2519/jospt.2007.2350 17877280
Comparative trends in utilization of MRI and ultrasound to evaluate nonspine joint disease 2003-2015 Journal of the American College of Radiology Kanesa-Thasan Riti M. Nazarian Levon N. Parker Laurence Rao Vijay Levin David C. 3 2018
15 3 pt A 402 407 1546-1440 10.1016/j.jacr.2017.10.015 10.1016/j.jacr.2017.10.015
Dramatically increased musculoskeletal ultrasound utilization from 2000-2009, especially by podiatrists in private offices Journal of the American College of Radiology Sharpe Richard E. Nazarian Levon N. Parker Laurence Rao Vijay M. Levin David C. 2 2012
9 2 141 146 1546-1440 10.1016/j.jacr.2011.09.008 10.1016/j.jacr.2011.09.008
Diagnostic accuracy of ultrasonography, MRI and MR arthrography in the characterisation of rotator cuff disorders: a systematic review and meta-analysis British Journal of Sports Medicine Roy Jean-Sébastien Braën Caroline Leblond Jean Desmeules François Dionne Clermont E MacDermid Joy C Bureau Nathalie J Frémont Pierre BMJ 11 2 2015
49 20 1316 1328 0306-3674 10.1136/bjsports-2014-094148 10.1136/bjsports-2014-094148 25677796
Musculoskeletal imaging: Medicare use, costs, and potential for cost substitution Journal of the American College of Radiology Parker Laurence Nazarian Levon N. Carrino John A. Morrison William B. Grimaldi Gregory Frangos Andrea J. Levin David C. Rao Vijay M. 3 2008
5 3 182 188 1546-1440 10.1016/j.jacr.2007.07.016 10.1016/j.jacr.2007.07.016 18312965
Sonography and MRI of the shoulder: comparison of patient satisfaction American Journal of Roentgenology Middleton William D. Payne William T. Teefey Sharlene A. Hildebolt Charles F. Rubin David A. Yamaguchi Ken 11 2004
183 5 1449 1452 0361-803X 10.2214/ajr.183.5.1831449 10.2214/ajr.183.5.1831449
Skeletal muscle ultrasound Neurological Research Pillen Sigrid van Alfen Nens 12 2011
33 10 1016 1024 0161-6412 10.1179/1743132811y.0000000010 10.1179/1743132811y.0000000010
The accuracy of diagnostic ultrasound imaging for musculoskeletal soft tissue pathology of the extremities: a comprehensive review of the literature Chiropractic & Manual Therapies Henderson Rogan E A Walker Bruce F. Young Kenneth J. 5 11 2015
23 1 31 2045-709X 10.1186/s12998-015-0076-5 10.1186/s12998-015-0076-5 26543553
Let’s all jump on the ultrasound bandwagon Ultrasound Edwards Hazel 2 2010
18 1 4 7 1742-271X 10.1258/ult.2009.009003 10.1258/ult.2009.009003
Long Head of the Biceps Tendon (LHBT) International Journal of Sports Physical Therapy Manske Robert C Voight Michael Wolfe Chris Page Phil 2 12 2022
17 7 2159-2896 10.26603/001c.55786 10.26603/001c.55786
Physical therapist use of diagnostic ultrasound imaging in clinical practice: A review of case reports Int J Sports Phys Ther Manske R.C. Podoll K.R. Markowski A. Watkins M. Hayward L.M. Maitland M.E. 2023
