| Tissue |
Proven indication |
Developing Indication |
Potential Indication |
| Effusion |
Diagnosis of joint, tendon sheath and bursal effusion. Aspiration of effusion. Differentiation of cystic from solid masses, detection of cyst rupture, sinus and fistula. Diagnosis of vascular and nerve compression syndromes by fluid collections |
Role of MSUS in improving efficacy of joint and bursal injection
|
Differentiation of type of effusion: US microscopy of synovial Fluid
|
| Synovium |
Diagnosis of synovial proliferation and synovitis |
Diagnosis of lesser degrees of synovitis. Differentiate active from inactive synovitis |
US used as standardized outcome measure for synovitis in RA trials. US used to classify joint involvement
(oligoarticular, polyarticular).
Development of tissue specific and
immunospecific contrast agents. US
synovectomy (high-intensity focused US) |
| Bursa |
Diagnosis of superficial and deep bursitis. Bursal aspiration and injection |
Differential diagnosis of true effusive bursitis from soft tissue inflammation (greater trochanter bursitis vs. greater trochanter enthesitis without effusion) |
Improve understanding of bursa
function and pathology |
| Bone |
Demonstration of joint erosion |
Diagnosis of fractures, bone tumors, periosteal disease |
US erosion included in diagnostic criteria
for RA.US erosion used as standardized
outcome measure in RA trials.
Differentiate active vascularized erosion
from inactive erosion
|
| Tendon/Ligament |
Diagnosis of tendon damage, rupture, tendonitis or tenosynovitis. Diagnosis of ligament injury or enthesitis. Improve assessment of indication for surgery |
Monitoring of response to therapy,
surgery. Role of MSUS in improving efficacy of tendon sheath and soft tissue injection
|
Differentiate active from inactive
enthesitis. Quantitative score of peripheral
enthesitis. Improve understanding of
pathogenesis of mechanical and
inflammatory enthesitis
|
| Skin |
Measure skin thickness in scleroderma. Detect subcutaneous oedema. Detect subcutaneous hypertrophy and atrophy, abscess, calcification, foreign body, nodule or tumors |
Application of skin thickness as a standard measure of outcome in, scleroderma. Objective monitoring of oedema after therapy. Monitoring of subcutaneous hypertrophy and atrophy, abscess, calcification,
foreign body, nodule or tumor |
Diagnosis of scleroderma. Differential
diagnosis of cellulitis, necrotizing fasciitis,
subcutaneous pathology |
| Cartilage |
Imaging of local and generalized cartilage defects and calcification |
Monitoring of cartilage thickness homogeneity cartilage disease |
Diagnosis of osteoarthritis and other
cartilage disease |
| Muscle |
Diagnosis of muscle trauma, tumor, abscess and calcification |
MSUS guidance of muscle biopsy, aspiration |
Diagnosis and monitoring of inflammatory muscle disease. Diagnosis and monitoring of muscle dystrophy |
| Vasculature |
Detection of inflammation with power Doppler. Imaging of location and morphology of vascular structures |
Objective and reproducible quantification of inflammation with power Doppler. Correlation of MSUS with histological diagnosis of temporal arteritis and vasculitis |
Imaging of ‘normal ’blood flow in joints. Diagnosis of temporal arteritis without recourse to biopsy. Diagnosis of medium and large vessel vasculitis. Diagnosis and monitoring of
Raynaud ’s disease |
| Nerve |
Demonstration of nerve morphology and continuity. Guidance of nerve blocks |
Diagnosis of peripheral nerve tumors and pseudotumours. Diagnosis of
nerve injury. Diagnosis of nerve entrapment carpal tunnel syndrome ulnar nerve compression, syndromes. MSUS demonstrates entrapment:, nerve pathology including axonal loss and common peroneal nerve at the fibular neck, posterior tibial nerve at the tarsal tunnel. |
MSUS as first-line diagnostic modality
for carpal tunnel syndrome and other
entrapment syndromes. MSUS demonstrates
nerve pathology including axonal loss and
demyelination |
| Salivary glands |
Demonstration of salivary gland size and morphology |
Correlation of MSUS findings with labial gland histology |
Diagnosis of Sjogren’s syndrome |