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World J Orthop. Feb 18, 2011; 2(2): 13-24
Published online Feb 18, 2011. doi: 10.5312/wjo.v2.i2.13
Ultrasound in the diagnosis of clinical orthopedics: The orthopedic stethoscope
Alexander Blankstein
Alexander Blankstein, Department of Orthopedics, Sheba Medical Center, University of Tel Aviv School of Medicine, 16 Kehilat Bavel St., Ramat Hasharon 47322, Israel
Author contributions: Blankstein A contributed wholly to this paper.
Correspondence to: Alexander Blankstein, Professor, Department of Orthopedics, Sheba Medical Center, University of Tel Aviv School of Medicine, 16 Kehilat Bavel St., PO Box 430, Ramat Hasharon 47322, Israel.
Telephone: +972-3-5409876 Fax: +972-3-5494269
Received: December 7, 2010
Revised: February 11, 2011
Accepted: February 15, 2011
Published online: February 18, 2011

Ultrasonography has advantages over other imaging modalities in terms of availability and comfort, safety, and diagnostic potential. Operating costs are low compared with both computed tomography (CT) and magnetic resonance imaging (MRI). The portable equipment is accessible at locations distant from medical centers. Importantly, ultrasonography is performed while patients lie in a comfortable position, without pain or claustrophobia. Ultrasonography is a totally safe noninvasive imaging technique. In contrast to CT and X-rays, it does not emit ionizing radiation. Unlike MRI, it is safe for all patients, including those with cardiac pacemakers and metal implants, without any contraindications. Of the many indications for musculoskeletal ultrasonography, the evaluation of soft tissue pathology is particularly common. In addition, ultrasonography is useful for the detection of fluid collection, and for visualization of cartilage and bone surfaces. Color or power Doppler provides important physiological information, including that relating to the vascular system. The capability of ultrasonography in delineating structures according to their echotextures results in excellent pictorial representation. This imaging principle is based on physical changes in composition, as compared to imaging with MRI, which is based on changes in chemical composition. This article reviews the contribution of sonography to the evaluation of the musculoskeletal system.

Keywords: Ultrasound, Orthopedic surgery, Safety, No radiation, Soft tissue