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Musculoskeletal Ultrasound

In recent years there has been a huge increase in the use of musculoskeletal ultrasound (MsK US) in orthopaedic and sports medicine. It is able to diagnose injuries to softs tissues, including muscles, tendons, nerves and ligaments, as well as joints.  In addition an increasingly number of highly trained physicians and health care providers are using US not just in diagnosis, but also in guided injection and interventional procedures. With t modern US technology, placement of needles is highly accurate, to under a millimetre.

Advantages of Diagnostic MsK US

  • Better soft tissue resolution than MRI

  • Dynamic or Real-Time ability, studying a problem area as it moves, for further detail of injury. Examples include shoulder impingement, joint instability and in giving more detail re size and degree of muscle tears by use of contraction and separation of torn fibres.

  • Ability to ‘see’ inflammation.

  • No radiation, no claustrophobia.

  • In office, immediate and convenient diagnosis.

  • Cost effective, a major draw in this day and age of hugely expensive imaging and unsustainable healthcare costs.

  • Ability to guide injections




  • US cannot penetrate bone as MRI can to ‘see’ into joints, so preventing full visualization of deeper joint and cartilage surfaces.


  • It is generally not as good as X-Ray for looking at bones (Nevertheless this clinic has picked up on several fractures not seen well on other imaging).


  • Msk USS is highly operator dependent . This means it takes a lot of training and effort to acquire sufficient skills in order to be competent.


Ultrasound guided injections


For years all physicans in this field always carried out ‘blind’ injections. Now that we have such accurate US technology, needle placement using US guidance helps ensure accurate delivery of medication/treatment, and of course helps in avoiding structures such as blood vessels, nerves or other organs. Patients are likely to have both improved comfort plus treatment efficacy.


At this time, Dr Carter is the only officially trained MsK US operator in Bermuda, with a post graduate certification In MsK US.