The Center for Podiatric Care and Sports Medicine

Why We Use Musculoskeletal Ultrasound

Posted by on Tuesday, July 23rd, 2013


Our New York podiatry office has a  musculoskeletal ultrasound imaging unit for the evaluation of tendon & muscle problems. New technological advances offer high-quality images to identify abnormalities, injury and soft tissue damage. Dr. Geldwert is proud to offer his patients the very best diagnostic imaging tools and most accurate diagnosis. In this post, we’ll discuss more about how musculoskeletal ultrasound is being used in advanced podiatry care.

What Is Musculoskeletal Ultrasound?

The musculoskeletal ultrasound works much like the ultrasounds used during pregnancy. Jelly is first applied to the skin and a transducer probe rides along the skin. The transmitter produces electrical energy, which is sent to the transducer to produce sound waves. The body returns echoes of those sound waves that reveal an image of the body’s internal tissues on the computer screen.

Why Is Musculoskeletal Ultrasound Used In Podiatry?

We have seen a dramatic increase in the use of musculoskeletal ultrasound in podiatry from 2000 to 2009. Podiatrists performed roughly 3,920 ultrasound imaging procedures in 2000, compared to 76,332 in 2009 — an increase of more than 18%. Substituting ultrasound for magnetic resonance imaging can save patients a lot of money. One study estimated that replacing MRI with musculoskeletal ultrasound from 2006 to 2020 would save more than $6.9 billion  — in the Medicare population alone!

In podiatry, we use the musculoskeletal ultrasound for the diagnosis of all tendon, muscle, ligament, nerve, and joint abnormalities. While the images might look rudimentary to the untrained eye, certified podiatrists are using diagnostic ultrasound as a valuable adjunct to the physical exam. We can use the ultrasound for pathologies that include (but are not limited to):

  • Achilles tendonitis, tears and ruptures
  • Ankle sprains, tissue damage
  • Bursitis
  • Cystic mass (ganglions)
  • Extensor and Flexor tendonitis, tears, ruptures
  • Foreign body presence
  • Joint problems
  • Ligament sprains and tears
  • Morton’s  neuroma
  • Muscle injury
  • Nerve damage
  • Patellar tendon injuries
  • Plantar Fascia tears and inflammation
  • Plantar Fibroma
  • Retrocalcaneal Bursitis
  • Stress factors
  • Tarsal Tunnel Syndrome
  • Tibialis posterior rupture or dysfunction
  • Ultrasound guided injection and/or aspiration
  • Wound severity

What Are The Benefits Of Musculoskeletal Ultrasound?

Aside from its obvious cost-effectiveness, Podiatry Today states that ultrasound is one of the safest types of imaging tools, with no known side effects or radiation. There is minimal patient preparation and it’s painless. Ultrasound allows for real-time diagnosis, which is invaluable in limiting pain for patients. Also, it can be used in patients who have metal implants, without causing distortion (as the MRI might). It’s also very good at discerning physical bodies from fluid bodies.

Sometimes we are able to see things in the ultrasound that cannot be seen in a clinical analysis or even a radiograph. In one case study mentioned by Podiatry Today, a 52-year-old female with three months of heel pain produced a rather unremarkable radiograph. Clinical analysis only identified that there was pain with palpation at the medial tuberosity and central inferior aspect of the calcaneus. However, the ultrasound technology showed thickened fascia and a well-formed cyst at the inferior aspect of the heel. Now the patient could be treated properly. In another case, a 48-year-old male who had been treated for plantar fasciitis for two years came in for an ultrasound and it was discovered that he, in fact, was suffering from multiple nerve compression. No wonder a night boot did not take care of his pain!


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.