What Is It Used For and When Is It Indicated?

Musculoskeletal ultrasound is used to diagnose and characterize the cause of pain or functional limitation. It is indicated in situations such as:

• Acute or chronic musculoskeletal pain, without a clear diagnosis or with poor progression.
• Suspected tendinopathies, partial tears, calcifications, or bursitis.
• Joint pain (knee, shoulder, hip, ankle, wrist) to assess effusion, synovitis, or periarticular injuries.
• Sports injuries, to assess the true extent of the damage and plan return to activity.
• Suspected nerve entrapments or peripheral neuropathies, in coordination with the patient’s clinical presentation.
• Follow-up assessment of injuries or inflammatory processes, to evaluate response to treatment.

In addition, in pain units such as ours, ultrasound is a fundamental tool because it allows diagnosis and treatment to be integrated into the same visit, improving the precision of the therapeutic plan.

What Advantages Does It Have Compared With Other Tests?

Ultrasound does not replace magnetic resonance imaging in every case, but it offers clear advantages:

• It is a fast and accessible test performed in the consultation room.
• It does not use radiation.
• It allows dynamic assessment (movement in real time).
• It supports direct clinical correlation: we can see exactly where it hurts.
• It is especially useful for tendons, bursae, effusions, and superficial structures.
• It allows structures to be assessed comparatively with the healthy side.

When required, we can recommend complementary tests (X-ray, MRI, CT scan) according to the findings and the clinical suspicion.

What Is the Procedure Like?

Diagnostic ultrasound is a simple, non-invasive procedure. It is performed during the consultation, with the patient in a comfortable position, and lasts approximately 10 to 20 minutes, depending on the complexity of the case and the region being examined.

Gel is applied to the skin, and the area is examined with an ultrasound probe. In many cases, we perform dynamic maneuvers or ask the patient to make small movements to reproduce the pain and observe how the structures behave.

At the end of the examination, the findings are discussed with the patient and a treatment plan is established. When necessary, the report may include recommendations for rehabilitation, exercises, changes in sports or work-related load, or an indication for interventional treatments.

Who Performs the Ultrasound?

The diagnostic ultrasound and clinical interpretation are performed by Dr. Ognen Poposki, a physician specializing in Physical Medicine and Rehabilitation, with specific training in ultrasound and ultrasound-guided interventions:

• Master’s Degree in Musculoskeletal Ultrasound and Ultrasound-Guided Interventions (UCEU)
• SERMEF Advanced Training Module: Neurosonography and Radiofrequency (nerve blocks and radiofrequency in pain and spasticity)
  This training makes it possible not only to see the image, but also to interpret the findings within the patient’s clinical context, integrating ultrasound into a complete diagnostic and therapeutic strategy.

What Can Ultrasound Detect?

Depending on the region, ultrasound can identify:

• Tendinopathies (inflammatory or degenerative), partial tears, and calcifications.
• Bursitis and joint effusions.
• Thickening, fibrosis, or changes in soft tissues.
• Muscle injuries (tears, hematomas, scars).
• Entrapments or irritation of peripheral nerves in selected contexts.
• Inflammatory changes in entheses and periarticular structures.

It is important to remember that ultrasound, like any imaging test, must be interpreted together with the clinical history and physical examination. The goal is not to find isolated findings, but to determine which injury truly explains the pain and how it should be treated.

Frequently Asked Questions

Does ultrasound hurt?
No. It is a painless examination. It may be uncomfortable if the area is very sensitive, but the test itself does not cause pain.

Do I need any preparation beforehand?
Usually not. In specific cases, we will tell you if there are any special recommendations.

Is MRI better?
It depends on the case. Ultrasound is excellent for tendons, bursae, effusions, and superficial structures, and it allows dynamic assessment. MRI is useful for deep structures, bone marrow, or complex injuries. In many cases, they are complementary.

Will I receive a diagnosis immediately?
In most cases, yes. Ultrasound makes it possible to guide the diagnosis and therapeutic plan during the same visit.

What is the cost?

• Diagnostic musculoskeletal ultrasound, 1 region: €90
• Ultrasound, 2 regions in the same visit: €140
• Complex or bilateral musculoskeletal ultrasound: €120

Evidence and Clinical Utility

Musculoskeletal ultrasound is widely accepted as a diagnostic and supportive tool in musculoskeletal and pain conditions, especially because of its ability to provide dynamic assessment and its integration into clinical practice. In a consultation focused on pain and ultrasound-guided intervention, it is a fundamental basis for guiding treatments precisely and improving outcomes.