Sonography (Ultrasound)

What happens inside a tendon when you move the joint? What causes swelling, and is there fluid in the joint? Questions like these can often be answered with an ultrasound exam right during your appointment. Ultrasound is therefore an important part of our orthopedic diagnostics at the ROC. It allows us to view muscles, tendons, ligaments, joints, and other superficial structures in real time—without X-rays. The ultrasound images are always evaluated in conjunction with your symptoms and the physical examination. This way, we not only see a structure but can also assess how it behaves during movement.

What is an ultrasound?

Sonography is the medical term for an ultrasound examination. A transducer emits sound waves into the tissue and receives the returning signals. The ultrasound machine then immediately generates an image of the examined body region. Because the images are generated in real time, we can examine joints, tendons, and muscles even while they are in motion. This is an important difference from many other imaging techniques, which primarily provide static images. Diagnostic sonography does not use ionizing X-rays.

What can we examine using ultrasound?

In orthopedics, ultrasound is particularly well-suited for visualizing superficial soft-tissue structures.

These include, among other things:

  • Tendons and tendon insertions
  • Muscles and Muscle Fascia
  • superficial ligaments
  • Bursae
  • Joint capsules
  • Joint effusions
  • Cysts and Other Fluid Accumulations
  • superficial nerves
  • Soft-tissue swelling
  • specific calcifications
  • the surface of bones

Which structures can be adequately visualized depends on their location, the affected body region, and the clinical question.

Typical Applications at the ROC

We use orthopedic ultrasound for the following conditions, among others:

  • Shoulder pain and suspected tendon changes
  • Problems with the biceps or rotator cuff tendons
  • Tennis or golfer's elbow
  • Hand and Wrist Pain
  • Suspected trigger finger or carpal tunnel syndrome
  • Muscle Injuries
  • Swelling or effusions in the joints
  • Baker's Cysts in the Knee
  • Pain in the Achilles or patellar tendon
  • Changes in the plantar fascia on the sole of the foot
  • Bursitis
  • sports-related strains
  • Follow-up Examinations for Known Changes

Not every change can be reliably assessed using ultrasound. That is why we decide after the examination whether additional images are needed.

Dynamic examination during movement

A particular advantage of ultrasound is the ability to observe structures while they are in motion. For example, we may ask you to bend, straighten, or rotate a joint. At the same time, we observe on the screen how tendons, muscles, or other structures behave. This can reveal, among other things, changes that are not visible or are less clearly visible when the joint is at rest. A comparison with the unaffected side can also be helpful in certain situations.

Here's how an ultrasound exam works at our clinic

We begin with a discussion of your symptoms. We’d like to know where the pain is located, how long it has been present, and which movements or activities make it worse. We then examine the affected area of the body. For the ultrasound, we apply a conductive gel to the skin and move the transducer over the area to be examined. Depending on the issue, we may move the joint during the examination or ask you to perform certain movements yourself. We see the images immediately on the screen and can compare any abnormalities directly with the physical examination. After the ultrasound, we’ll explain what’s visible in the images and whether further tests are recommended.

Ultrasound-Guided Treatments at the ROC

At the ROC, we use ultrasound for more than just diagnosis. For certain procedures, it also helps us monitor the position of an injection needle or a minimally invasive instrument. During the procedure, we can visualize the target area and adjacent structures in real time. This allows us to continuously monitor the position of the needle or instrument.

We use ultrasound examinations for, among other things:

  • Selected joint injections
  • certain infiltrations of the spine
  • Punctures of Fluid Accumulations
  • selected rejuvenating treatments
  • the minimally invasive Spirecut® treatment for trigger finger or carpal tunnel syndrome

Whether ultrasound-guided treatment is appropriate depends on the target structure and the individual's medical condition. For more information, please visit our pages on infiltration therapies and the Spirecut® treatment.

What can't an ultrasound show?

Ultrasound is particularly well-suited for superficial soft-tissue structures. However, sound waves cannot penetrate bone. Therefore, structures inside a bone or behind bony areas cannot be adequately visualized.

Depending on the body region, even deeper structures may be difficult to assess.

For certain types of problems, other methods are therefore more appropriate:

  • Digital X-rays for bone fractures, bone deformities, and signs of osteoarthritis
  • Digital volume tomogram for selected three-dimensional representations of bony structures
  • Open MRI for deeper soft tissues, menisci, cruciate ligaments, intervertebral discs, and other complex conditions

The choice of which procedure is appropriate depends on the medical question that needs to be answered.

Benefits of Ultrasound at the ROC

Orthopedic Ultrasound Examination:

  • does not require ionizing X-rays
  • enables real-time display
  • can be performed while moving
  • allows for comparison with the opposing party if necessary
  • is usually painless
  • can be repeated if the question is appropriate
  • Supports select image-guided treatments

Since we have an ultrasound machine right here in our office, we can compare the images immediately with the physical examination and existing findings.

Schedule an appointment in Aschheim

ROC Ortho
Private Orthopedic Practice
St.-Emmeram-Str. 5
85609 Aschheim

Email: praxis@roc-ortho.de
Phone: +49 89 46259930

Opening hours

Monday7:30 a.m. – 6:00 p.m.
Tuesday7:30 a.m. – 6:00 p.m.
Wednesday7:30 a.m. – 8:00 p.m.
Thursday7:30 a.m. – 6:00 p.m.
Friday7:30 a.m. – 3:00 p.m.