What is a Muskuloskeletal ultrasound?

Musculoskeletal ultrasound (MSK-US) is a non-invasive, radiation-free imaging modality that uses sound waves to visualize joints and tendons. MSK-US is especially helpful in the diagnosis and surveillance of many rheumaticImage of Ultrasound machine conditions, such as rheumatoid arthritis and psoriatic arthritis. Use of MSK-US can clarify physical exam findings, identify joint inflammation and damage, and detect bone damage (erosions) in all stages of disease. Ultrasound can also be used to help guide medication injection into joints or tendons and can also be used to obtain tissue from a joint for analysis.  

MSK-US is the same technology used to look at the heart (echocardiogram) or exam the abdomen in pregnancy to visualize the fetus. 

What can ultrasound see?

Below is a typical image from an ultrasound examination of the shoulder. Considerable training is required to correctly position the ultrasound transducer to acquire useful images and interpret them. MSK-US is best for ligaments, tendons, looking inside joints, and examining cartilage. It is not as useful for examination of boney structures.

Image of ultrasound photo

What does an MSK-US examination entail?Image of ultrasound transducer.

The examiner will likely do a brief physical examination of the area in question and then apply gel to the area to be examined. Gel helps transmit sound waves to the tissues.  The transducer (see right) will be applied to your skin and moved to various locations to visualize the tissues. MSK-US examinations usually take 30-60 minutes to complete. 

The Division of Rheumatology at the University of Washington has a world class program for teaching rheumatologists-in-training musculoskeletal ultrasound and your visit to the ultrasound clinic will likely include a rheumatology fellow as well as a faculty member certified as a musculoskeletal ultrasonographer.

How can MSK-US help your care team?

Some of the important issues that ultrasound can help with include:

  • Looking for the presence of joint inflammation in people suspected of having an inflammatory form of arthritis not confirmed by physical examination
  • Monitoring disease activity/efficacy of therapy in people with inflammatory arthritis such as rheumatoid arthritis
  • Identify the cause/extent of damage to tendons in people with suspected rotator cuff disease of the shoulder or other tendon problems
  • Removing fluid from a joint for analysis
  • Guiding injections of cortisone and other medications into joints such as the shoulder, hip, or ankle, areas difficult to access without direct visualization.
  • Examining for enthesitis (inflammation where tendons and ligaments connect to bone) in patients with certain inflammatory diseases
  • Looking for crystals on joint surfaces to confirm a diagnosis of gout

Image of Rheumatologist performing ultrasound exam on a patient.

Faculty certified to preform MSK-US

Scott Pollock, MD

Ingeborg Sacksen, MD

Sarah Chung, MD

Clinic Locations

UWMC Roosevelt Rheumatology Clinic

4245 Roosevelt Way, Seattle WA, 98105

Fax 206-598-6822

Harborview Medical Rheumatology Clinic

Main Hospital, West Clinic , 325 9th Ave., 3rd Floor, Seattle, WA 98104

Fax 206-744-8527

Referrals to the MSK-US clinic are accepted by referral from your provider and can be faxed to the numbers noted above. We currently do not accept self-referred patients.