Diagnostics
Ultrasound of joints and soft tissues
Your shoulder hurts when you raise your arm, a joint is swollen or a tendon becomes painful with activity. You would like to know which structure may be involved and whether an investigation can provide greater clarity.
Open individual sections or all the details on this page.
Understanding
A closer look
Ultrasound, also called sonography, can be used to examine certain joint and soft-tissue structures. Images are produced during the examination and can also be assessed during movement. The method helps answer selected questions but does not replace every other type of imaging. What matters is what needs to be clarified in your situation.
When ultrasound may be helpful
Ultrasound can show structures such as tendons and bursae, as well as collections of fluid around joints. Depending on the area examined, it can identify changes that help explain your symptoms. A bursa is a cushioning sac that helps neighbouring structures move against each other and can change when irritated.
With a swelling, the question may be whether there is fluid inside the joint or whether a neighbouring structure is affected. With tendon symptoms, the appearance of the tissue can be assessed. What can be determined in an individual case also depends on the structure’s position and accessibility.
Why movement can help during the examination
Some symptoms occur only when you raise your arm or make another particular movement. As ultrasound images are produced in real time, we can observe selected structures as you move. You may be asked to move a joint gently into a suitable position.
Your feedback matters: is this your familiar pain, or does it feel different? Please also tell us if a movement is very painful or makes you feel unsure. We adapt the examination to what you can manage. This lets us consider the visible movement alongside what you feel, without determining the cause of pain from the image alone.
Further information
How ultrasound differs from X-rays and MRI
Ultrasound uses sound waves and does not use X-rays. It can provide a targeted assessment of readily accessible superficial soft tissues in particular. An X-ray, by contrast, mainly shows the bones. Depending on the question being considered, an MRI can show deeper structures and other tissues.
The methods therefore serve different purposes. For example, ultrasound does not replace a full assessment of the inside of every joint. If the suspected cause cannot be adequately assessed with ultrasound, another approach may be helpful. An investigation is chosen according to the clinical question, not according to which device can show the most.
What happens during the examination
Gel is applied to the skin over the area being examined. It provides contact between the skin and the ultrasound probe. The doctor moves the probe over the area and views the images produced. Different positions or a comparison with the other side may be used where appropriate.
The examination is usually easy to tolerate. However, pressure on an area that already hurts or a particular movement can be uncomfortable. Tell us straight away if this happens. You do not need to endure pain to obtain a “good” examination result. The gel is removed afterwards.
How the image relates to your symptoms
We compare the ultrasound findings with the location of your pain, the course of your symptoms and the physical examination. A visible change in a tendon may fit your symptoms without fully explaining them. A normal finding is also useful information and does not mean that your pain is unimportant.
We explain what could be assessed and which questions remain open. This determines whether treatment is appropriate, whether to monitor progress initially or whether another investigation would help. Additional imaging should support a decision; it is not automatically the next step.
Ultrasound at OrthoCoast
Your contacts for musculoskeletal ultrasound are Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling and Björn Weidemann. The scan complements an orthopaedic assessment when it can answer a specific diagnostic question about a joint or soft tissues.
If ultrasound has been recommended, or you would like a swelling or persistent symptoms assessed, tell us about your needs through patient services. A joint that suddenly becomes very warm and swollen, with fever or an inability to bear weight, needs prompt medical assessment. Do not simply wait for a routine examination appointment in this situation.
What to expect and next steps
Preparing for the scan and what to do afterwards
A routine musculoskeletal ultrasound scan usually requires no special preparation. Clothing that allows easy access to the relevant body region makes the process easier. Existing reports and information about earlier injuries or operations are helpful.
After the scan alone, you can generally carry on with your day. If a needle aspiration or injection is also planned as part of the visit, it will have its own instructions and a separate discussion before consent. A diagnostic ultrasound scan does not automatically mean that treatment will be performed.
Our doctors in this specialty
Priv. Doz. Dr. med. habil.Richard Kasch
Specialist in orthopaedics and trauma surgery
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Dr. med.Christoph Jährling
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
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Björn Weidemann
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileHere you can see the doctors who interpret your findings. Together, we discuss what the results mean for your ongoing treatment.
Frequently asked questions
Can ultrasound explain why a tendon hurts?
For certain tendons, it can show changes that contribute to the assessment. Whether these actually explain the pain is considered alongside your symptoms and physical examination. An image alone does not always answer the question.
Is an ultrasound scan painful?
You cannot feel the sound waves themselves. Pressure from the probe or a movement being assessed may be uncomfortable in an irritated area. Tell the doctor if this happens so that the examination can be adapted.
Why is an MRI sometimes recommended after an ultrasound scan?
Some deep structures or structures obscured by bone can only be assessed to a limited extent with ultrasound. If the cause is thought to lie there, or a further decision depends on it, another imaging method may add useful information.
How long does an examination take?
This depends on the area, the clinical question and any movement tests needed. The full appointment may also include a consultation and examination. A reliable time estimate can therefore only be given for the particular appointment arranged.
Will I need a rest or someone to accompany me after an ultrasound scan?
For an ultrasound scan alone, the procedure does not usually require a recovery period or someone to accompany you. If additional measures are planned or you need support in everyday life, this should be arranged separately.
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