Ultrasound examination of the hip joint in adults


Ultrasound diagnostics have been used in medicine for quite a long time, and the emergence of new high-tech digital devices equipped with high-frequency sensors has made it possible to use this method in rheumatology.

Nowadays, ultrasound of joints is one of the advanced methods for diagnosing diseases whose symptoms are characterized by joint pain. This technology is absolutely safe, affordable, and, importantly, provides the patient with complete information about the problem.

Why is a lower extremity examination performed?

Soft tissues, cartilage and bones have different densities. Ultrasonic waves are reflected from their surface in different ways. This allows you to get an informative black-and-white image on the monitor screen of special equipment, from which a doctor can diagnose a particular pathology. Ultrasound of the legs or lower extremities usually involves the diagnosis of diseases of the hip, knee, ankle and foot joints.

Experts recommend that if you experience discomfort, uncharacteristic sounds and various pains in the joint area, after injuries, with arthrosis or arthritis, as well as rheumatic diseases, do an ultrasound of the lower extremities, the price of which is reasonable. If dysplasia is suspected in infants, it is also necessary to undergo an ultrasound examination of the hip joints.

What does an ultrasound of joints show?

This technology makes it possible to examine soft tissues that are inaccessible with X-ray examination. Using ultrasound of joints, you can assess the condition of muscles, cartilage, tendons, and joint capsules. In addition, you can identify various tumors, determine cartilage degeneration, see the presence of ruptures, hematomas and other abnormalities.

Where in Moscow can I get an ultrasound of the joints? Ultra-modern medical equipment makes it possible to conduct a highly informative examination of the musculoskeletal system and establish an accurate diagnosis even when other diagnostic methods (for example, X-ray examination) cannot give an accurate result.

In addition, our medical center in the Eastern Administrative District of Moscow offers you an ultrasound of the joints at the most affordable prices.

FAQ

  • Is it painful to have an ultrasound examination?

    No, this is a non-invasive and painless diagnostic method.

  • Will ultrasound be enough to make a diagnosis?

    It all depends on the disease; for some diseases, only an ultrasound is sufficient, while others will require a more in-depth examination, such as magnetic resonance imaging or blood tests.

  • Does ultrasound replace radiography of the joint?

    No, ultrasound does not make it possible to assess the nature of the bone fracture, the presence of fragments and displacement. Therefore, in case of injuries and suspected fracture, it is better to first conduct an X-ray diagnosis.

  • How is ultrasound of joints and soft tissues performed?

    Everything is extremely simple: the doctor applies a special gel to the area under study, this gel helps ultrasound penetrate the tissue, and with the help of a sensor examines the tissues and processes occurring under the skin.

  • How often can an ultrasound be done?

    The ultrasound diagnostic method is absolutely harmless; if necessary, it can be done as many times as necessary.

  • Is it possible to consult a specialist after an ultrasound?

    Yes, you can get advice from a specialized specialist - a traumatologist, orthopedist, physiotherapist or sports doctor. You can also undergo treatment with us, and you can start on the same day you contact us.

Reviews about the joint ultrasound procedure in our clinic

15.06.14

Our family is very grateful to the doctors of your clinic. My father has had arthritis for a long time, but the stage was quite difficult to determine. In February, I took my father for an ultrasound at Onmed, and it was here that we finally received a good consultation. Thanks to experienced specialists, the degree of destruction in the joints was determined and treatment was prescribed. And the pain goes away, and movements return every day. Thank you very much! Sincerely, Igor.

24.03.14

An ultrasound scan at the ONMED clinic helped me with the correct treatment. Recently I started having constant pain in my hands. I visited several clinics, but received different comments everywhere. And in this center they explained everything to me in detail and answered all my questions regarding the previous findings. I am very grateful to your center for your attention and the highest quality medical care. Tamara Sergeevna.

Make an appointment!

  • palpable mass formation in soft tissues;
  • observations during the treatment of inflammatory diseases of the joints and tendons (tenosynovitis, arthritis, tendinitis);
  • suspicion of a cyst or rupture of a Becker cyst;
  • observations for bursitis.

Why do they contact us?

What does ultrasound of joints diagnose?

This technology makes it possible to examine soft tissues that are inaccessible with X-ray examination. Using ultrasound of joints, you can assess the condition of muscles, cartilage, tendons, and joint capsules. In addition, you can identify various tumors, determine cartilage degeneration, see the presence of ruptures, hematomas and other abnormalities.

Ultra-modern medical equipment makes it possible to conduct a highly informative examination of the musculoskeletal system and establish an accurate diagnosis even when other diagnostic methods (for example, X-ray examination) cannot give an accurate result.

In addition, we offer you an ultrasound of the joints at the most affordable prices in Moscow.

Who interprets the results and how to obtain them?

The radiologist, a doctor specially trained to monitor and interpret x-ray studies, will analyze the images and send a signed report to your primary care physician or other health care provider who requested the analysis. Typically, the referring doctor or health care provider will share the results with you. In some cases, the radiologist may discuss the results with you at the end of your examination.

Follow-up inspections may be required. Your doctor will explain the exact reason for requesting another test. Sometimes follow-up testing is done because the potential abnormality needs further evaluation with additional views or special imaging techniques. In addition, follow-up testing may be required so that any change in the known abnormality can be monitored over time. Follow-up examinations are sometimes the best way to see whether treatment is working or whether the result is stable or changes over time.

You can sign up for a consultation and find out more from the administrator by calling +7 (495) 356-30-03.

How does this procedure work?

Ultrasonic imaging is based on the same principles as sonar used by bats, ships and fishermen. When a sound wave hits an object, it bounces back or echoes. By measuring these echo waves, one can determine how far away an object is, as well as the size, shape, and consistency of the object (whether the object is solid or filled with liquid).

In medicine, ultrasound is used to detect changes in the appearance, size or contour of organs, tissues and blood vessels, or to detect abnormal masses such as tumors.

In an ultrasound scan, a transducer sends sound waves into the body and receives echo waves. When the sensor is pressed against the skin, it sends small pulses of inaudible, high-frequency sound waves into the body. As sound waves bounce off internal organs, fluids and tissue, a sensitive receiver in the transducer records tiny changes in sound and sound direction. These signal waves are instantly measured and displayed by a computer, which in turn produces a real-time image on a monitor. One or more frames of moving images are usually captured as still images. Short videos (image streams) can also be saved.

Ultrasonography of the knee joints (methodology and ultrasound anatomy)

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Introduction

In modern radiation diagnostics, ultrasonography plays a leading role, and the scope of its application is constantly expanding. If 15-20 years ago ultrasound diagnostics was widespread only in the classical zone - obstetrics and gynecology, uronephrology, abdominal organs, then in the last decade, thanks to the improvement of equipment, the development of new methodological techniques, it has become possible to use echography in those areas that were previously considered inaccessible to ultrasound.

One such direction in the development of ultrasonography is its use in traumatology and orthopedics [1-5], in particular, for examining knee joints.

Research methodology

The study is carried out with linear or convex sensors with a frequency of 5 to 10 MHz. In this case, the ultrasound diagnostic doctor must know not only the normal and ultrasound anatomy of the joint being examined, but also strictly follow the proposed ultrasound scanning protocol.

An anatomical feature of the structure of the knee joint is the presence of menisci - triangular-shaped cartilaginous plates located between the articular surfaces, penetrating a certain distance into the articular cavity (Fig. 1, 2). The outer edge of the meniscus fuses with the articular capsule, the inner edge is pointed in the shape of a wedge and faces the joint cavity.

Rice. 1.

Knee joint: a - front view, b - cross section.

1 - femur, 2 - lateral femoral condyle, 3 - ant. cruciate lig., 4 - post. meniscofemoral lig., 5 - post. cruciate lig., 6 - capsular lig.; 7 - fibula, 8 - tibia, 9 - tibial coll. lig., 10 - medial meniscus, 11 - medial femoral condyle, 12 - medial meniscus, 13 - lateral meniscus, 14 - ant. cruciate lig., 15 - trans. lig., 16 - post. meniscofemoral lig., 17 - post. cruciate lig.

Rice. 2.

Knee joint: side view.

1 - femur, 2 - tibia, 3 - m.quadriceps tendon, 4 - superior inversion of the knee, 5 - bursa of the anterior part of the patella, 6 - fat bodies, 7 - patellar ligament, 8 - deep patellar bursa, 9 - patella .

Traumatic injuries and diseases of the meniscus are one of the most common causes of pain in the knee joint.

At the beginning of the study, the patient is lying on his stomach, legs slightly bent at the knees. The sensor is located in the area of ​​the popliteal fossa parallel to the long axis of the lower limb at the site of maximum pulsation of the artery, determined by palpation, and on the monitor screen this position serves to determine the correct position of the sensor (Fig. 3).

Rice. 3.

Ultrasonogram and diagrams of the posterior knee joint.

1 - femur, 2 - tibia, 3 - joint space, 4 - popliteal artery, 5 - medial head of gastrocnemius.

Under the control of the researcher’s hand, the sensor is shifted laterally along the projection of the joint space until a wedge-shaped echo-positive structure of moderate intensity appears on the screen, corresponding to the posterior horn of the lateral meniscus (Fig. 4).

Rice. 4.

Ultrasonogram and projection diagrams of the posterior horn of the meniscus.

1 - femur (external condyle), 2 - tibia, 3 - posterior horn of the lateral meniscus, 4 - lateral head of the gastrocnemius, 5 - joint space.

In this case, before visualization of the posterior horn of the meniscus, a sesamoid bone is sometimes detected (Fig. 5).

Rice. 5.

Ultrasonogram, diagram of the popliteal region and sensor location.

1 - femur, 2 - lateral head of m.gastrocnemius, 3 - sesamoid bone.

Then the patient turns to the painful side, the leg bends at the knee to 50-60°, the sensor is located in the projection of the joint space above the intermediate part of the meniscus and gradually moves anteriorly until the structure of the anterior horn is visualized on the monitor screen. The medial meniscus is examined similarly (Fig. 6).

Rice. 6.

Ultrasonogram, diagram of the medial knee joint and sensor location.

1 - femur, 2 - tibia, 3 - medial meniscus (middle portion), 4 - m.sartorius.

Examination slightly below the popliteal region of the knee joint at an angle of 60° from the longitudinal section allows visualization of the medial and lateral heads of the gastrocnemius (Fig. 7).

Rice. 7.

Ultrasonogram, diagram of the popliteal region and sensor location.

1 - tibia, 2 - medial head of gastrocnemius, 3 - lateral head of gastrocnemius, 4 - popliteal artery.

Rotating the ultrasound sensor 90° from the longitudinal axis of the limb in the projection of the femur makes it possible to visualize the medial and lateral femoral condyles, the vessels of the popliteal region, and partially the posterior and anterior cruciate ligaments (Fig. 8).

Rice. 8.

Ultrasonogram, diagram of the popliteal region and sensor location.

1 - medial condyle, 2 - lateral condyle, 3 - vessels of the popliteal fossa, 4 - fatty bodies, 5 - part of the posterior cruciate ligament, 6 - part of the anterior cruciate ligament.

Examination of the anterior knee joint allows one to evaluate the condition of the patella, quadriceps tendon, patellar ligament, fat pads and superior inversion of the knee joint (Fig. 9-17).

Rice. 9.

Ultrasonogram, diagram and location of the sensor when examining the anterior knee joint.

1 - lower edge of the patella, 2 - tibia, 3 - fat bodies, 4 - patellar ligament, 5 - deep patellar bursa.

Rice. 10.

Ultrasonogram, diagram and location of the sensor when examining the upper part of the knee joint.

1 - patella, 2 - patellar ligament, 3 - place of attachment of the ligament, 4 - subcutaneous fat.

Rice. eleven.

Ultrasonogram, diagram and location of the sensor when examining the lower part of the knee joint.

1 - tibia, 2 - patellar fat bodies, 3 - patellar ligament.

Rice. 12.

Ultrasonogram, diagram and location of the sensor when examining the knee joint at rest.

1 - lower edge of the patella, 2 - femur, 3 - tibia, 4 - patellar ligament.

Rice. 13.

Ultrasonogram, diagram and location of the sensor during the study of the knee joint with tension in the m.quadriceps.

1 - lower edge of the patella, 2 - femur, 3 - tibia, 4 - patellar ligament.

Rice. 14.

Ultrasonogram, diagram and location of the transducer during a transverse examination of the upper part of the knee joint.

1 - patellar ligament, 2 - fatty bodies.

Rice. 15.

Ultrasonogram, diagram and location of the sensor when examining the lower part of the knee joint.

1 - tibia, 2 - internal bursa of the patella, 3 - proper patellar ligament.

Rice. 16.

Ultrasonogram and diagram of the lower femur and patella.

1 - upper pole of the patella, 2 - femur, 3 - quadriceps tendon, 4 - adipose tissue.

Rice. 17.

Ultrasonogram and diagram of the insertion site of the m.quadriceps tendon in a cross section.

1 - m.quadriceps, 2 - femur.

Ultrasound protocol of the knee joint

The ultrasound report of the knee joint should reflect the following items:

  • Presence of effusion in the superior recess (yes, no).
  • Echostructure of the liquid (homogeneous, heterogeneous).
  • Presence of foreign bodies (yes, no).
  • Rectus femoris tendon (integrity broken, not broken).
  • Patella—contours (smooth, uneven), presence of bursitis (yes, no).
  • Own ligament - integrity (broken, not broken), structure (uniform, heterogeneous, reduced echogenicity), thickness, presence of bursitis (yes, no).
  • Condition of fat bodies (structure changed, not changed), hypertrophy (yes, not).
  • Condition of the mediopatellar fold - structure (changed, not changed), damage (yes, not).
  • Lateral ligaments - structure (changed, not changed), presence/absence of tendon diastasis during a functional test.
  • Articular surfaces of the femur and tibia (smooth, uneven), bone growths (yes, no), the presence of additional inclusions (yes, no).
  • Hyaline cartilage - contours (smooth, uneven), thickness (thinned, within normal limits - up to 3 mm).
  • Menisci: external - shape (regular, irregular), structure (homogeneous, heterogeneous), contours (clear, unclear; even, uneven), fragmentation (yes, no), calcification (yes, no), presence of fluid formation in the paracapsular zone (yes, no); internal - the shape, structure, contours, presence of fragmentation, calcification, paracapsular zone are described in a similar way.
  • Presence of a Becker cyst in the popliteal region (yes, no).

Literature

  1. Mironov S.P., Eskin N.A., Orletsky A.K., Tsykunov M.B. A new method of testing using sonography for damage to the ligaments of the knee joint // Proc. report VI Congress of the European Society of Sports Traumatology and Knee Arthroscopy. - Berlin, 1994. - P.43.
  2. Eskin N.A. Comprehensive assessment of injuries and diseases of soft tissues and joints / Dissertation. ...Dr. med. Sci. - M., 2000.
  3. Fornage BD Ultrasonography of Muscules and Tendons // Springer - Verlag. NewYork, 1988. 227 p.
  4. Petersen LJ, Rasmunssen OS ULscanning som diagnostik metode ved mistanke om menisklaesion i knaeet. Prospektiv blindet undersogelse af 52 patient // Ugersk Laeger, 1999, 161 (41): 5679 - 5682.
  5. Yabe M., Suzuki M., Hiraoka N., Nakada K., Tsuda T. A case of intraarticular fracture of the knee joint with three layers within lipohemarthrosis by ultrasonography and computed tomography // Radiat Med., 2000, 18 (5) : 319 – 321.

Ultrasound scanner HS60

Professional diagnostic tools.
Assessment of tissue elasticity, advanced 3D/4D/5D scanning capabilities, BI-RADS classifier, options for expert cardiological studies.

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