What can an MSK ultrasound scan show—and when might you need a different test?
Updated: Sep 20
MSK ultrasound can show selected superficial muscles, tendons, ligaments, bursae, joints and lumps in real time. It cannot show every cause of pain, and a normal or abnormal scan must be interpreted alongside the history and physical examination.
What is musculoskeletal ultrasound?
Musculoskeletal ultrasound uses high-frequency sound waves rather than ionising radiation. The probe can be moved while the patient moves, allowing the sonographer to assess a structure dynamically and compare it with the other side. It is particularly useful for many superficial soft tissues.
What can an MSK ultrasound scan assess?
Rotator cuff and long-head biceps tendons at the shoulder
Achilles and other superficial ankle tendons
Some ligament injuries, bursae and joint fluid
Tendon tears, tendinopathic change and calcification
Selected superficial lumps, swellings and soft-tissue lesions
What can ultrasound not assess well?
Ultrasound is not a routine test for spinal discs, nerve roots, bone marrow, deep hip structures or much of the internal knee. X-ray, MRI, CT, blood tests or specialist assessment may be more suitable depending on the clinical question.
Why examination comes before imaging
Scans often identify structural changes in people who have no pain. Before recommending imaging, we clarify the location, symptom behaviour, injury mechanism and functional loss, then test the likely tissues. The useful question is not simply 'what does the scan show?' but 'will this result change treatment or referral?'
What happens at Ben Cohen Osteopathy?
Diagnostic MSK ultrasound is available at our Epping clinic. The region is examined systematically, relevant dynamic tests may be used, and the findings are explained in the context of the clinical presentation. The result can guide rehabilitation, further imaging or medical referral. No GP referral is required for this private service.
When might a different test be needed?
Suspected fracture or significant bone injury
Possible spinal disc or nerve-root pathology
Deep joint, labral or bone-marrow pathology
A lump with concerning clinical or ultrasound features
Symptoms suggesting infection, cancer or another systemic condition
Frequently asked questions
Does an abnormal scan always explain pain?
No. Imaging findings need to match the painful movement, examination and history. Treating the report rather than the person can lead to unnecessary worry or unsuitable treatment.
Is ultrasound the same as therapeutic ultrasound?
No. Diagnostic ultrasound creates images. Therapeutic ultrasound is a treatment modality and does not produce a diagnostic scan.
Can ultrasound decide whether I need shockwave therapy?
It may help confirm or exclude relevant pathology in selected cases, but shockwave suitability also depends on symptoms, examination, previous rehabilitation and contraindications.
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Evidence and further reading
This article provides general information and cannot diagnose an individual problem.
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