Appropriate Conditions for Medical Ultrasound



Appropriate Conditions for Medical Ultrasound (Based on work by Klauser et al 2012 - Clinical indications for musculoskeletal ultrasound: A Delphi-based consensus paper of the European society of musculoskeletal radiology )

|Evidence |Consensus Grading |

|Level A: Consistent RCT, cohort study, All or none clinical decision rules validated in different |Grade 3: US is first choice level technique (other investigations rarely provide more information). |

|populations |Grade 2: US indication equivalent to other imaging investigations (other imaging might provide |

|Level B: Consistent retrospective cohort, exploratory cohort, outcomes research, case control study; or |significant information) |

|extrapolations from level A studies |Grade 1: US indicated if other imaging techniques are not appropriate |

|Level C: Case-series study or extrapolations from level B studies |Grade 0: US not indicated |

|Level D: Expert Opinion without explicit critical appraisal or based on physiology, bench research of | |

|first principles | |

|Shoulder |Grade 3 (US 1st Line) |Grade 2 (US = to other imaging) |Grade 1 (US only indicated if other techniques |Grade 0 (US not indicated) |

| | | |not available) | |

| |Full thickness cuff tear (A) |Partial Thickness Cuff tears (A) |Rotator Cuff Muscle Atrophy (B) |Adhesive Capsulitis (B) |

| |Calcific Tendonitis (B) |Post-op cuff failure (B) |Loose Bodies © |GHJT Instability (B) |

| |Long head of biceps tendon rupture (B) |Long head of biceps tendinopathy (B) |Quadrilateral Space Syndrome © | |

| |Long head of biceps tendon dislocation (B) |A/C Joint trauma/instability (B) |Thoracic Outlet Syndrome © | |

| |Bursitis (c) |A/C Joint OA © | | |

| |Septic Arthritis (C) |Sternoclavicular joint disease © | | |

| | |Suprascapular Nerve Entrapment © | | |

| | |Pectoralis major/deltoid tears © | | |

| | | | | |

|Elbow |Lateral Epicondylitis (A) |Medial Ligament © |Loose Bodies © |Lateral Collateral Ligament (D) |

| |Medial Epicondylitis (NO) |Screening Elbow Trauma © |Radial Head Subluxation/Fracture (D) | |

| |Synovitis (B) |Biceps Tendon Insertion (No) |Osteochondral Injury (No) | |

| |Septic Arthritis / Effusion (B) |Bicipitoradial Bursitis (No) | | |

| |Triceps Injury © | | | |

| |Snapping Triceps Syndrome (D) | | | |

| |Olecranon Bursitis (D) | | | |

| |Radial Nerve Compression (No) | | | |

| |Medial Nerve Entrapment Syndrome, Pronator | | | |

| |Syndrome (No) | | | |

| |Ulnar Nerve Neuropathy (D) | | | |

| |Ulnar Nerve Subluxation (D) | | | |

| | | | | |

|Wrist |Joint Synovitis (b) |Finger Collateral Ligament Injury © |Finger Fracture © |Hamate/Capitate/ © |

| |Mass Examination © |Intersection syndrome © |Scaphoid Fracture © |Triangular Cartilage © |

| |Pulley/sagittal band/central slip injury © |Pisiform Triquetral OA © |Scapholunate Ligament © |Abutment Syndromes © |

| |Trigger finger © |Volar Plate Avulsion © | | |

| |Ganglion cyst © |Scaphotrapezio-trapezoidal OA © | | |

| |Tenosynovitis/ Rupture © | | | |

| |Extensor carpi ulnaris/ ulnar collateral | | | |

| |ligament © | | | |

| |Foreign Body © | | | |

| |De quervains tenosynovitis © | | | |

| |Carpal Tunnel Syndrome © | | | |

| |Guyons Canal © | | | |

| |Wartenberg Syndrome © | | | |

| |Flxor Carpi ulnaris/radialis (D) | | | |

| | | | | |

|Hip |Fluid Detection (A) |Hamstrings (B) |Muscle Injuries (low grade) (B) |Intra-articular OA of hip (A) |

| |Snapping Hip – extraarticular (A) |Anterior Tendinopathy © |Trochanteric Pain © |Labral Tears © |

| |Synovitis/ Effusion/ Synovial Cysts (A) |Trochateric Pain – for injection © |Growing Pains © |Septic Effusion (D) |

| |Muscle Injuries High Grade (B) |Sciatica Thigh (D) |Psoas Tendon Pathology © |Snapping Hip (Intra-articular) (D) |

| |Lateral Femoral Cutaneous Nerve © |Bursitis (D) |Sciatic Pelvic Pain (D) | |

| |Femoral (D) | | | |

| |Sports Hernia (D) | | | |

| | | | | |

|Knee |Patellar/ Quad Tendiopathy/osis (A) |Medial Collateral Ligament (A) |Posterolateral Corner (B-C) |ACL Tears (A) |

| |Bakers Cyst (A) |Retinacula Pathology (B) |Loose Bodies (B) |Meniscal Tears (A) |

| |Periarticular Bursitis (A) |Knee Arthroplasty Infection (B) |Hoffas Fat Pad syndrome (D) |Synovial Tumours (B) |

| |Periarticular Ganglion (A) |Meniscal Cyst (B) |Intracrticular Ganglion (D) |Knee Fractures (B) |

| |Osgood-schlatter, Sinding larsen (A) |ITB Friction © | |PCL Tears (B-C) |

| |Synovitis, Effusion (A) |Gastroc insertion © | |Osteochondral Dissecans © |

| |Septic Arthritis (a-b) |Semitendinosis, semimenbranosus tendon © | |Plica Syndrome © |

| |Pes Anseriunus Tendonobursitis © | | | |

| | | | | |

|Ankle |Tendon Tears (A) |Mortons Neuroma (A) |Deltoid Ligament (A-B) |Posterior Talo-fibular Ligament (D) |

| |Tendon Sheath Effusion (A) |Haglunds Deformity (A-B) |Bony Avulsion (B) |Intraarticular Disease (D) |

| |Peroneal Sheath Effusions (A) | |Spring Ligament (D) |Cartilage Lesions (D) |

| |Calcific Tendinitis (A) | |Loose Bodies (D) | |

| |Retrocalcaneal Bursitis (A) | | | |

| |ATFL, Calcaneal Fig Ligaments Tears (A) | | | |

| |Ganglion Cysts (A) | | | |

| |Nerve Entrapment (A) | | | |

| |Synovitis (A) | | | |

| |Plantar Fascitis (A) | | | |

| |Post Operative Tendon Tear (B) | | | |

| |Joint Effusion (C-D) | | | |

| |Retinacula (D) | | | |

| |Tendinopathy (D) | | | |

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