20 + years ago, most everyone in medicine had not heard of MSK Sonography, and those who had, scoffed at the idea due to the presence of MRI. Today, as I am privileged to participate and assist in workshops and conferences around the country, I have observed that MSK has become an informational monster. It is common to hear comments of feeling overwhelmed during the first morning session of a two or three-day workshop. MSK Ultrasound can quickly become a daunting task instead of an exciting addition to a practitioner’s skillset.
The opening lecture of my MSK Fundamentals has one slide that has not been changed or updated for over 15 years. Why? Because it still works. It still helps people “get it”. It is a simple description of how to obtain and interpret MSK images in a reproducible and efficient fashion. The slide is below . . . A straightforward algorithm to performing MSK.
A portion of the slide is cut off by intention. It states that it is not your job to hunt pathology. By following the scanning protocols religiously, and understanding normal sonoanatomy completely . . .pathology will present itself! This raises the objectivity of the images and minimizes the user variability issues. Clinical signs in presentation often will not be collaborated on ultrasound images. Allow the ultrasound to do its own work. Follow the protocols. Endeavor to produce normal anatomy . If you cannot. . . then the finding is reliable.