Interventions Lecture 8: Ultrasound

Question 1

Therapeutic Ultrasound

Answer 1

• used to reduce pain, increase circulation and increase mobility of soft tissues
• helpful in the reduction of inflammation, reducing pain and the healing of injuries and wounds

Question 2

US Imaging

Answer 2

High frequency broadband 
sound waves that are 
reflected by tissues to 
varying degrees to 
produce an image

Question 3

Ultrasound Imaging AKA

Answer 3

MSK US imaging

Rehabilitative Ultrasound Imaging (RTUI)

Question 4

Use of MSK ultrasound imaging in Rehab

Answer 4

Treatment Guidance
Use as biofeedback 
Track swelling
Tissue integrity
Document changes in clinical conditions
Guide needle for dry needling
Track blood flow or inflammation

Question 5

Charing for MSK ultrasound

Answer 5

• no CPT code

- charge for activity you are doing (i.e., Neuromuscular re-education or therapeutic exercise)

Question 6

Curvilinear Transducer/Probe

Answer 6

-Wide far field
 Small footprint
 Good for deeper structures

Question 7

Linear Transducer/Probe

Answer 7

 Wide near field

 Small superficial structures

Question 8

Hyperechoic

Answer 8

more
echogenicity than the
surrounding tissues

Question 9

Isoechoic

Answer 9

same
echogenicity as the
surrounding tissues

Question 10

Hypoechoic

Answer 10

less echogenic

than the surrounding tissue

Question 11

Aneochic

Answer 11

absence of echoes

Question 12

Echogenecity of cortical bone

Answer 12

Anechoic with hyperechoic rim

Question 13

Echogenicity of tendons & ligaments

Answer 13

Hyperechoic, distinct parallel fiber

pattern

Question 14

Echogeniticty of muscle

Answer 14

Hyperechoic, parallel fibrous

hyperechoic bands

Question 15

echogenecity of hylaine cartilage

Answer 15

Hyperechoic layer

Question 16

echogenicity of cysts or fluid filled structures

Answer 16

Anechoic

Question 17

Short axis

Answer 17

transverse view

Question 18

long axis

Answer 18

longitudinal view

Question 19

Advantages of MSK US

Answer 19

Dynamic
 Can assist in defining the clinical question
 Generally unaffected by metal
 No radiation to patient or user
 Can compare to contralateral extremity
 Relatively inexpensive
 Allows viewing of deep musculature

Question 20

Disadvantages of MSK

Answer 20

Limited field of view
 Incomplete evaluation of bones & joints
 Operator dependent
 Lack of formal education
 Cost & availability of PTs
 Variable quality

Question 21

MSK US biofeedback

Answer 21

Ability to image in real-time 
Dynamic
Fast
Interactive
Allows patient can view feedback

Question 22

What happens to the superficial and deep lumbar spinal musculature with lumbar dysfunction?

Answer 22

TrA: delayed recuritment; decrease fascial slide
Multifidus: atrophies quickly, increased fatty infiltraation
Pelvic floor musculature: weakness or increased tone

Question 23

Use of MSK US imaging in Rehab

Answer 23

May augment ability to contract transverse abdominis
Reduced number of trials needed to perform abdominal
hallowing exercise
No enhancement of hollowing

Biofeedback
Improved activation of multifidus muscle
Healthy subjects
Improved training of pelvic floor muscles
32/56 (57%) correct activation with less than 5 min of
training