MSK ultrasound works best when a clinician has a focused question. It may help assess structures close to the skin and the way they move. Your symptoms, examination, injury history and the body area determine whether ultrasound, X-ray, MRI or another route is appropriate.
What does an MSK ultrasound assess?
In an MSK scan, the examiner uses a probe and gel on the skin to create a moving image. NHS describes musculoskeletal ultrasound as an examination of muscles, tendons, joints and soft tissues.[1]
Peer-reviewed literature describes a role for ultrasound in selected questions involving tendons, ligaments, muscles, nerves, bursae and joint fluid. It can also allow the examiner to view some structures during movement. A normal or abnormal image needs interpretation alongside the clinical picture.[2]
Tendon and muscle symptoms
Ultrasound may help assess a tendon, muscle or the tissues around a joint when a clinician has a focused question.
Ligament or soft-tissue injury
For selected superficial structures, ultrasound can form part of the assessment after a strain, sprain or other injury.
Joint fluid and bursae
A scan may show fluid around a joint or bursa. The finding needs interpretation alongside the symptoms and examination.
Nerve or superficial lump symptoms
In selected situations, ultrasound may help assess a nerve or a superficial soft-tissue concern. It does not replace the wider clinical pathway.
How it fits with other tests
Ultrasound and MRI have different strengths. Neither test is best for every symptom. A clinician may consider the location of the problem, whether the question involves a superficial soft tissue or deeper structure, the examination findings and whether another test could change management.
For example, X-ray, MRI or a specialist assessment may be more appropriate in some situations. An ultrasound report supports the next decision; it does not replace a physical examination or establish every cause of pain.
If a scan is being considered after an injury, share the mechanism of injury, when symptoms started, changes in movement, any previous imaging and the medicines you use. Those details can help the clinician choose a proportionate pathway.
Ultrasound
May help assess selected soft tissues and movement-related questions.
X-ray
May be considered where bone injury or another bony question is relevant.
MRI
May be considered when the clinical question requires a different view of deeper or more complex structures.
What to expect during an MSK scan
The examiner may ask you to expose the area being assessed. You may lie on a couch or sit beside the ultrasound machine. They place gel on the skin and move a small probe over the area. They may ask you to change position or move a joint.[1]
Pressure over a sore area can be uncomfortable. Tell the examiner if you need to pause, change position or have a question about the examination. The clinic confirms preparation, appointment structure, reporting and follow-up at booking.
The images form one part of the information available to your clinician. The next step can range from self-care advice or clinical review to another test or urgent assessment, depending on your symptoms and the result.
When symptoms need urgent help
Do not wait for a routine scan if you have sudden, severe pain. NHS says to call 999 or go to A&E for sudden severe pain in any part of the body. It describes severe pain as pain that makes it hard to think, sleep or move.[3]
For urgent symptoms that are not clearly life-threatening, NHS 111 can help direct you to the right service. Your symptoms may need urgent assessment rather than outpatient imaging.[4]
Seek urgent care first
Call 999 or go to A&E for sudden, severe pain. Use NHS 111 if you need medical help now and are unsure whether you need emergency care. Do not use a routine scan booking as an urgent-care route.
Related information
These pages can help you understand the available routes. They do not replace clinical assessment for new, worsening or urgent symptoms.
Questions to take to an appointment
What clinical question is the scan intended to answer?
Is ultrasound the appropriate test for this body area and symptom?
Would an X-ray, MRI or another assessment be more useful?
Which parts of my injury history or symptoms matter most?
How should I prepare for the area being examined?
What should I do if pain or movement changes before the appointment?
Frequently asked questions
What is an MSK ultrasound?
An MSK ultrasound uses high-frequency sound waves to create moving images of muscles, tendons, joints and other soft tissues. It is one type of imaging used in a musculoskeletal assessment.
What can it help assess?
Depending on the question, ultrasound may help assess tendons, muscles, ligaments, nerves, bursae or joint fluid. A clinician should interpret the report with your symptoms, examination and history.
Is an MSK ultrasound better than an MRI?
Ultrasound and MRI answer different questions. A clinician chooses between ultrasound, X-ray, MRI or another pathway based on the body area, symptoms, examination and the clinical question. One test does not replace all the others.
What happens during the scan?
The examiner may need access to the area being assessed. They place gel on the skin and move a probe over it. You may be asked to change position or move the body part. Preparation and the appointment structure are confirmed at booking.
Will it be uncomfortable?
An MSK ultrasound can involve pressure over a sore area and may feel uncomfortable. Tell the examiner if you need to change position or pause. The experience varies with the body area and the underlying symptoms.
Can ultrasound guide an injection?
Ultrasound can support guidance for some procedures, but whether a procedure is appropriate depends on a separate clinical assessment. The clinic confirms the relevant route, suitability and follow-up arrangements at booking.
When is limb pain urgent?
Call 999 or go to A&E for sudden, severe pain in any part of the body. NHS identifies severe pain that makes it hard to think, sleep or move as an emergency symptom. NHS 111 can guide you when you need medical help now and are unsure of the right service.
References
- [1]Newcastle Hospitals NHS Foundation Trust. Ultrasound musculoskeletal scan.
- [2]Shah AB, Bhatnagar N. Ultrasound imaging in musculoskeletal injuries: What the Orthopaedic surgeon needs to know. Journal of Clinical Orthopaedics and Trauma. 2019.
- [3]NHS. Compartment syndrome.
- [4]NHS. When to use NHS 111 online or call 111.