As a practicing Radiologist for 20 years, I was generally familiar with Musculoskeletal Ultrasound, as to its use predated MRI for soft tissue evaluation. I was certain, however, that MRI was the “Gold Standard” for evaluating musculoskeletal pathology. After watching a shoulder evaluation, it became clear that sonography offered a different set of benefits from MRI.
First, the resolution obtained with high-frequency transducers allows detailed depiction of superficial structures.
Second, sonography is portable, more available, and less expensive.
Third, interventional procedures, such as joint aspiration, can be guided with sonography once an abnormality is detected.
Fourth, and possibly most important, dynamic examination of sonography may detect abnormalities that are not obtainable with MRI.
Finally, there are several contraindications for MR imaging that do not exist with sonography.
Based on my experience over the past five years with Advanced Ultrasound Imaging, I believe that Ultrasound will become the primary imaging study for all soft-tissue abnormalities, with CT and MR secondary.
I encourage all physicians to consider utilizing musculoskeletal ultrasound procedures as a front-line diagnostic study for soft-tissue injury cases, with a special emphasis on shoulders and knees.