From the Guidelines
Ultrasound of an extremity that is nonvascular and performed in real time with image documentation is a valuable diagnostic tool for evaluating soft tissue structures in the arms or legs, and it should be performed with proper documentation, including the indication for the procedure, a description of the organs or structures identified, and an interpretation of the findings, as recommended by the American College of Emergency Physicians 1. This procedure involves using high-frequency sound waves to create images of muscles, tendons, ligaments, joints, and other soft tissues. The "real time" aspect means the images are displayed immediately as the ultrasound is being performed, allowing the technician or physician to observe movement of structures and make dynamic assessments. Image documentation refers to the capturing and storing of these ultrasound images for medical record purposes and future comparison. This type of ultrasound is commonly used to diagnose conditions such as:
- Tendon tears
- Muscle strains
- Joint effusions
- Soft tissue masses
- Foreign bodies
- Other abnormalities in the extremities. The procedure is painless, non-invasive, and does not use radiation, making it a safe option for patients of all ages, and the examination typically takes about 15-30 minutes depending on the area being evaluated and the complexity of the condition, as noted in guidelines for emergency ultrasound imaging criteria 1. Proper documentation is essential, and it should include the indication for the procedure, a description of the organs or structures identified, and an interpretation of the findings, and images should be stored as part of the medical record whenever feasible 1.
From the Research
Ultrasound for Extremity Nonvascular Procedures
- Ultrasound has been shown to be effective in visualizing soft tissues and nonvascular structures in the extremities 2.
- It can be used to guide interventional procedures for chronic pain management, providing improved visualization of anatomy and avoiding ionizing radiation 3, 4.
- Ultrasound has been used to treat various conditions, including tendinitis, bursitis, and musculotendinous injuries, with some studies suggesting its effectiveness in promoting soft tissue healing 5, 6.
Real-Time Imaging with Documentation
- Real-time ultrasound imaging allows for accurate visualization of the anatomy and guidance of interventional procedures 3, 4.
- Image documentation is an essential aspect of ultrasound-guided procedures, enabling clinicians to record and review the procedure for future reference 2.
- The use of ultrasound for extremity nonvascular procedures has been shown to be safe and effective, with minimal risks and complications 5, 4.
Benefits and Limitations
- The benefits of using ultrasound for extremity nonvascular procedures include improved visualization, reduced radiation exposure, and increased accuracy of delivery 3, 4.
- Limitations of ultrasound include its inability to penetrate bony structures and potential bioeffects, such as thermal-based therapies and mechanical-based therapies 5, 6.
- Further studies are needed to fully appreciate the role of ultrasound in chronic pain management and to standardize its use in clinical practice 4, 6.