USS Examination Techniques for the assessment of common pathologies of the Shoulder, Knee and Wrist in Family Medicine
Hyo-Sun YOU and Jun-Hyuk LEE
It is estimated that 18.8 million people in the UK are living with a musculoskeletal(MSK) condition. It is a major cause of morbitidy and a significant reason for presentation to primary care. MSK presentations account for a large proportion of GP workload. The prevalence is rapidly increasing with an ageing population. There is currently no structured GP curriculum for MSK common pathologies. Ultrasound(USS) performs extremely well for tendons and superficial soft tissues of shoulder, knee and wrist—often equal to or better than MRI for dynamic tendon issues. USS assessment of common MSK conditions has a significant higher diagnostic accuracy compared to clinical examination alone in conditions such as: [1]Carpal Tunnel Syndrome Based on median nerve cross-sectional area measurement. [2]De Quervain’s Tenosynovitis Dynamically visualizes tendon sheath swelling and stenosing tenosynovitis. [3]Quadriceps / Patellar Tendinopathy Particularly good at showing thickening and neovascularity. 4[]Baker’s Cyst Ultrasound is the preferred first-line tool. [5]Collateral Ligament Injuries [6]Joint Effusion / Synovitis Excellent for volume estimation and guiding aspiration. [7]Subacromial/Subdeltoid Bursitis Good for detecting fluid or synovial thickening. [8]Biceps Long Head Tendinopathy / Subluxation Dynamic scanning makes ultrasound better than MRI for instability. [9]Acromioclavicular Joint PathologyTo provide a guide to the clinical & USS assessment of common MSK conditions of the shoulder, knee and wrist in general practiceSession 1: Shoulder Session 2: Knee Session 3: Wrist Each session will consist of – 15 minutes audivisual lecture covering sonographic anatomy and USS image acquisition technique and examples of common pathology – 45 minutes hands- on practical demonstration of USS image acquisition on a volunteer modelParticipants will gain a deeper understanding of the clinical and sonographic assessment of the common conditions [1] to [9] see contextIt is important for GPs to perform shoulder, knee, and wrist ultrasound because it: Improves diagnostic accuracy at the point of care. Leads to quicker and more appropriate treatment. Supports safer, more accurate injections. Reduces unnecessary referrals and imaging. Enhances patient satisfaction and service efficiency. Saves costs and supports modern primary-care roles.
