Dynamic Sonography of Joints and Soft Tissues

This article reviews the wide variety of joint and soft-tissue disorders that can be diagnosed using dynamic sonography. The authors discuss dynamic maneuvers that enhance its diagnostic power and that can be easily incorporated into the sonographic examination. Many of these disorders cannot be diagnosed by any other imaging method. Sonography is a useful and rapidly evolving technique for the investigation of many joint and soft-tissue disorders. Sonography is well suited for examinations of the musculoskeletal system because structures are often superficial, examinations may be done in a position that is comfortable for the patient, and comparisons with the contralateral side are possible. In addition, the real-time imaging capability of sonography is a particularly advantageous feature, permitting dynamic evaluation of a system of movement. Sonography is increasingly recognized as complementary to cross-sectional modalities. Some disorders of muscles, tendons, nerves, and joints can best be observed-and some can only be observed-when demonstrated dynamically during motion of the extremity, muscle contraction, probe compression, or position change of the patient. In this review, we discuss dynamic maneuvers that can be incorporated into the sonographic examination of each peripheral joint and of extra-articular soft tissues.