Injuries are a part of professional and even amateur sports. One can take precautions but cannot prevent these injuries outright. However, these injuries are sometimes challenging to detect, as athletes may not feel much pain during the acute period and continue to play. This may mean delayed diagnosis and initiation of the rehabilitation process. In some instances, such a delay may have long-term consequences for athletes. It means quick diagnosis and identification of sports injuries is the key to recovery.
However, sports physicians and coaches are often faced with the dilemma of whether to continue training, give the person a rest, or send for further diagnosis. This is because diagnosis in the field is challenging. However, musculoskeletal ultrasound can change these things, enabling quick and reliable diagnosis of the conditions in the field. So, on this page, we will discuss how high frequency linear ultrasound and thus allows athletes to have on-time treatment for quicker rehabilitation.
Musculoskeletal Ultrasound in Medical Assistance During Sports Events
Musculoskeletal Ultrasound has emerged as a valuable tool in the field of medical assistance and support, particularly during sporting events. These portable devices offer real-time imaging capabilities that allow medical professionals to quickly assess and diagnose injuries or medical conditions on the spot.
- Timely diagnosis: Acute injuries are inevitable in sports competitions, common ones include muscle strains, ligament tears, fractures, etc. Musculoskeletal(MSK) ultrasound allows medical staff to clearly and quickly observe anatomical images of tendons, ligaments, nerves, joint capsules and other tissue structures without waiting for the injured to be transported to a medical institution.
- Comprehensive and accurate: Musculoskeletal ultrasound often uses high-frequency handheld ultrasound. High-frequency ultrasound can directly display the dynamic pathological changes of muscle, soft tissue and bones, which is more comprehensive than MRI that can only display images at a specific moment. In addition, the wireless design of high-frequency ultrasound is more flexible and versatile. The probe angle can be adjusted according to the patient’s position, such as the anterior talofibular ligament, ankle deltoid ligament and other structures.
- Monitoring Rehabilitation: After an injury, monitoring the healing progress is crucial. Handheld ultrasound devices enable medical staff to track the healing process of tissues and bones. This information helps in adjusting rehabilitation protocols and estimating an athlete’s readiness to return to play.
- Vascular Assessment: Minimally invasive treatment: Some serious muscle injuries may cause hematoma, so timely puncture and fluid extraction are required to avoid the formation of blood clots. After the ultrasound diagnosis, the physician can quickly perform minimally invasive interventional treatment under ultrasound guidance. Determine the viscosity of the liquid based on the echo of the effusion and the degree of extrusion deformation and select the corresponding needle to effectively avoid important tissues such as nerves and blood vessels for puncture and aspiration.
- Preventive Screenings: Before participating in high-intensity sports, athletes undergo pre-participation evaluations. High frequency linear ultrasound scanners can be used for cardiac and abdominal screenings to identify any underlying conditions that might pose risks during physical exertion.
Musculoskeletal Ultrasound in Post-Sport Event Rehabilitation
The application of Musculoskeletal Ultrasound in post-sport event rehabilitation is a crucial aspect of ensuring athletes’ prompt and effective recovery. These portable devices offer real-time visualization of internal structures, which aids medical professionals and physical therapists in assessing healing progress, identifying potential complications, and tailoring rehabilitation programs. Here’s how Musculoskeletal Ultrasound applied in the rehabilitation process after sporting events:
- Assessment of Healing Progress:
Muscle and Tendon Healing: High frequency liner ultrasound scanners are used to monitor the healing of muscles and tendons after injuries like strains or tears. By visualizing the tissue quality, thickness, and alignment, therapists can gauge how well the injured area is being repaired and adapt treatment plans accordingly.
Bone Fracture Healing: In cases of bone fractures sustained during sporting events, ultrasound imaging helps track the healing process. Medical professionals can assess callus formation, alignment, and signs of delayed healing, allowing them to modify weight-bearing recommendations and rehabilitation exercises.
- Guidance for Rehabilitation Exercises
Precise Targeting: High frequency liner ultrasound scanners assist in accurately guiding rehabilitation exercises. Therapists can visualize the injured area in real-time while an athlete performs specific movements, ensuring that the exercises are properly targeted and avoiding strain on healing tissues.
Muscle Activation Monitoring: Ultrasound imaging helps assess muscle activation and contraction during exercises. This feedback is valuable for ensuring that athletes are engaging the correct muscles and following the prescribed rehabilitation protocols.
- Preventing Complications
Adhesions and Scar Tissue: After injuries, scar tissue and adhesions can develop, affecting joint mobility and muscle function. High frequency linear ultrasound scanners help identify these issues early on, enabling therapists to incorporate techniques to minimize their formation and improve tissue mobility.
Monitoring Edema: Edema or swelling is common after injuries. Ultrasound imaging can quantify the extent of swelling and track its reduction over time. This information guides the application of techniques like compression, elevation, and lymphatic drainage to prevent complications.
- Return to Play Assessment
Structural Integrity Check: Before athletes can safely return to their sports, it’s crucial to ensure that healing is sufficient and the injured structures are stable. High frequency linear ultrasound helps medical professionals confirm that tissues are adequately healed and capable of withstanding the demands of physical activity.
- Functional Testing
Ultrasound scans can be used in conjunction with functional testing to evaluate an athlete’s readiness to return to play. By assessing muscle strength, range of motion, and tissue integrity, therapists can make informed decisions about the appropriate timing for resuming sports activities.
- Patient Education and Motivation
Visual Feedback: Ultrasound imaging provides athletes with visual feedback on their recovery progress. Seeing the healing process and improvements firsthand can boost motivation and adherence to rehabilitation exercises and protocols.
Understanding Anatomy: Athletes gain a better understanding of their anatomy and the extent of their injuries through ultrasound imaging. This comprehension can lead to better compliance with rehabilitation programs and a more active role in their recovery.
Diagnostic Musculoskeletal Ultrasound in Sports Medicine
Musculoskeletal ultrasound is not a stranger for many. It refers to a noninvasive imaging test that can present real-time internal body conditions using high-frequency sound waves[1]. And in the fickle world of sports arenas, handheld ultrasound, with higher flexibility and portability than the traditional ultrasound that only operates in hospitals, is used all the time.
In sports campaigns, contusions of soft tissue, sprained articular ligament, and pulled muscles commonly happen, and the high frequency linear ultrasound can provide real-time diagnoses to find out the wounded spot and seriousness to make a quick and accurate treatment decision.
Musculoskeletal Ultrasound Increases the Accuracy of Diagnosis and Treatment
Musculoskeletal ultrasound is commonly used for diagnosis during sporting events and daily exercise. Musculoskeletal ultrasound refers to the direct observation of pathological changes in human tendons, ligaments and other soft tissues, cartilage and bone surfaces through high-frequency ultrasound. Compared with traditional MRI examinations, musculoskeletal ultrasound (msus) can display dynamic images with clear anatomical layers of muscles, ligaments, tendons, and bone tissues, which is helpful for doctors to clearly diagnose common sports injuries such as tendon and ligament rupture, neurovascular extrusion, and intra-articular effusion and swelling. Let’s take a look at the common diagnostic cases and images of musculoskeletal ultrasound.
- Muscle strains
In confrontational sports such as football and basketball, athletes are often attacked by sudden external forces. For example, the vastus intermedius muscle and lateral muscles of football, rugby and hockey players often come into hard contact with the ball, which is a common site for muscle injuries.
Direct trauma may result in localized hematoma, contusion, partial or complete muscle tearing. Edema and obvious inflammatory infiltration often appeared 48 hours after injury. After a week, fibrous tissue begins to replace the inflammatory response and form scarring.
Muscle injuries under high-frequency ultrasound scans can generally be classified into four grades:
Grade 0: The injured area is red, swollen, and painful when pressed, but no obvious abnormality is found on the sonogram.
Grade 1: The muscle boundaries are blurred, the normal feathering structure of local muscles disappears, and the echo is reduced but not interrupted. Part of the muscle fiber is torn, but the fascia remains intact.
Grade 2: The muscle echo is partially interrupted, and a hypoechoic fissure appears at the broken end and is surrounded by a hematoma. Fluid accumulates around the fascia within the muscle abdomen, combined with epimysial rupture and bleeding that spreads outward. A large number of muscle fiber tears, accompanied by partial fascial tears.
Grade 3: The muscle echo is completely interrupted, the muscle retracts, a large fissure appears and is filled with hematoma. The muscle fibers and fascia are completely torn.
During the scanning, physicians need to pay attention to the depth of the injury site, the involved structures and scope, and the internal echo. Moreover, need to observe the blood flow inside the lesion and try to make the sound beam perpendicular to the muscles and tendons under examination to reduce anisotropic artifacts.
- Ligament damage
Ligament injuries are mostly caused by sprains and strains, especially of the anterior cruciate ligament of the knee, which are common among athletes in football, basketball, skiing, wrestling and judo. When the ligament is subjected to high loads, the collagen fiber bundles are stretched beyond the yield point and inelastic lesions occur beyond the limit of rupture. Ligament injuries often occur in the knee and ankle joints. The lateral collateral ligaments of the ankle joint are relatively weak, and most are injuries to the anterior talofibular ligament.
Symptoms of the anterior talofibular ligament are usually easily ignored in the early stages of injury. If necessary ankle joint braking measures are not taken in time, sequelae such as stiffness, ankle joint instability, and cartilage damage may easily occur in the later stage. High-frequency ultrasound scanning can provide doctors with reliable images in a timely manner and help doctors determine whether fixation is needed.
High-frequency ultrasound can easily show the extent, location, and extent of ligament damage. Even if it is an old injury, the scope and extent of the injury can be confirmed through the fluid dark area of the ligament.
When performing musculoskeletal ultrasonic examination, it is preferable to choose a high-frequency probe of 10-15MHz, and place the probe perpendicular to the skin surface. First, perform a longitudinal scan along the long axis of the ligament, and gently press the probe at the tender points for continuous multi-section scanning. By applying pressure to the anterior talofibular ligament with the probe, the dynamics sonogram of ligament damage can be observed.
Common ultrasound images of ligament injuries: Thickening of the anterior talofibular ligament, reduced echo, partial or complete interruption of fiber continuity, and irregularity of the femoral surface at the lateral malleolus attachment point of the ligament can be observed.
Ultrasound-visualized anterior drawer test:
The anterior drawer test can determine whether the anterior talofibular ligament is partially or completely torn.
During the examination, the patient needs to put his foot downward and perpendicular to the side of the bed. The examiner holds the patient’s foot around the heel and then applies an anterior force steadily through it.
At the same time, the distance from the broken end of the anterior fibular ligament to the broken end of the anterior fibular ligament is observed under the ultrasound scan. If the broken ends are separated, then A complete tear can be diagnosed.
- Fracture
Fracture is the most common injury in sports competitions. At the 2016 Rio Olympics, 26-year-old French gymnast Samir Ait Said fractured his left leg on the spot due to an unstable center of gravity during landing, and his left calf was bent at 90 degrees, known as one of the most serious injuries in the Olympics.
High-frequency wireless ultrasound has gradually become the first choice for emergency diagnosis in competitions. Since X-rays are limited by the angle and method of scanning, it cannot detect early signs of fractures, such as small fractures of the local bone cortex, subperiosteal hematoma, and periosteum caused by stress fractures.
Additionally, high-frequency ultrasound scans can identify potential fracture lines, which is especially obvious when diagnosing rib fractures. Rib fractures often have cortical cracks, separation or displacement. Plain films cannot show displaced fractures, but high-frequency wireless ultrasound can perform long-axis and short-axis sections of the ribs based on the anatomy of the chest, which makes wireless ultrasound easier to find occult fractures.
Placing high-frequency wireless ultrasound on areas with swelling, congestion, or limited mobility, physicians can clearly observe interruptions in bone cortex continuity, subperiosteal hematoma, soft tissue swelling, and congestion on your mobile phone or tablet. High-frequency ultrasound can also display early-stage diagnosed callus, providing a more comprehensive basis for diagnosis. Let’s take a look at the ultrasound scans of different types of fractures: X-ray and ultrasound comparison chart:
a. Linear fracture:
Linear fractures show interruptions in the continuity of the bone cortex under high-frequency ultrasound scanning, dislocation of the broken ends, local periosteal thickening and echo enhancement, and more blood flow signals in the surrounding soft tissues.
b. Avulsion fracture:
Ligament strain is often accompanied by avulsion of the attached bone. Abnormal strong echoes at the distal ends of the tendons or ligaments can be observed under ultrasound scanning, and hematoma echoes can be seen in the surrounding soft tissues.
- Cartilage injury-Torn meniscus
The meniscus is a pair of elastic fibrocartilage located between the femur and tibia, which main function is to increase the stability of the femoral condyle and tibial platform, absorb shock, and assist in lubrication. When the knee joint is in flexion and the tibia is fixed, the lower end of the femur is affected by external force and suddenly excessive internal rotation or extension can easily lead to a medial meniscus tear. If the lower end of the femur is suddenly externally rotated or straightened, it can easily lead to a tear of the lateral meniscus.
25% of lateral meniscus tears can heal through the formation of fibrocartilage, but 75% of medial meniscus tears cannot heal by themselves. Therefore, many great athletes such as Ronaldo and Kaká have to end their athletic careers early due to their meniscus injuries.
Because cartilage is transparent to X-rays, it is difficult to detect fracture lines with conventional X-rays. Handheld wireless ultrasound can perform multiple axial scans without being limited by the angle of the fracture line, clearly displaying the echoes on the cartilage surface and inside the cartilage.
Physicians can also complete dynamic ultrasound examinations through musculoskeletal ultrasound, especially for cases of dynamic meniscal protrusion, which only protrudes when it is stressed, so it is difficult to detect lesions with either MRI or X-ray. However, dynamic ultrasound can scan the lesion while manipulating the limb, and is more helpful in discovering occult lesions.
Meniscal tear ultrasound image: High-frequency wireless ultrasound can help doctors determine the extent of meniscal tears. When only minor tears occur, the image mostly appears as wire-bound hyperechoicity. When the tear is complete, two highly echogenic interfaces accompanied by a hypoechoic band are observed. The wedge-shaped structure disappears, the edges are irregular, and obvious fluid accumulation is visible.
- Ultrasound-guided surgery in musculoskeletal medicine
Some serious muscle injuries may cause hematoma, so timely puncture and extraction of fluid are required to avoid the formation of blood clots. After the diagnosis is made by musculoskeletal ultrasound examination, the doctor can quickly perform minimally invasive interventional treatment under ultrasound guidance. Based on the echo of the effusion and the degree of extrusion deformation, the doctor can judge the viscosity of the liquid and select the corresponding needle, effectively avoiding important tissues such as nerves and blood vessels to perform puncture and aspiration to avoid blind puncture failure or complications caused by injecting drugs outside the tendon sheath and into the tendon.Learn more from https://www.viatomcare.com/what-is-the-musculoskeletal-ultrasound/.
Viatom High Frequency Linear Ultrasound
Viatom offers top-notch portable ultrasound to redefine the diagnosis of sports injuries and rehabilitation protocols to facilitate optimum recovery. The following is our high-frequency ultrasound designed specifically for musculoskeletal ultrasound examinations.
This high frequency linear ultrasound has a frequency range of 10-14 MHz and a maximum penetration depth of 80mm below the skin. The image quality is comparable to in-vehicle ultrasound systems, without the complicated knobs and switches.
Viatom high frequency linear ultrasound integrates 5 imaging modes: B mode, B+M mode, PW mode, Color mode, and Power mode. Moreover, it is compatible with smartphones and tablets and iOS or Android operating systems. This feature facilitates outdoor diagnosis due to its ability to provide premium-quality images at high speed.
Real-Time Scanning Through Built-in Wi-Fi Hotspot
Our high frequency linear ultrasound features a Wi-Fi hotspot. It takes seamless connectivity to the next level. This cutting-edge feature allows real-time visualization of sports injuries and facilitates optimizing well-being.
Wi-Fi connectivity allows physicians to share images at once with colleagues or patients. It fosters a cooperative approach and remote consultations.
This real-time scanning enables quick decision-making and streamlines the athlete’s recovery.
Wireless Charging and Long Battery Life
Viatom high frequency linear ultrasound offers wireless charging technology that makes the process convenient and effortless. It eradicates the hassle of tangled cords and cables.
Moreover, say goodbye to limited battery life. Our dual-head scanner offers a long battery life of more than 3 hours, which ensures prolonged scanning sessions without repeated interruptions. So, in sports rehab systems, professionals can rely on this product confidently.
Conclusion
In short, high frequency linear ultrasound plays a pivotal role in revolutionizing sports rehabilitation. By providing quick and real-time imaging, these portable scanners help in dynamic analysis. Likewise, they facilitate a more precise assessment of musculoskeletal elements and optimize the overall health condition.
Viatom, as the world’s leading healthcare device provider, has been developing our technologies, aiming to provide more reliable and advanced medical devices that will cater to growing complicated demands. For years, our monitoring instruments have been approved by the market, acting as diagnostic accuracy and efficiency boosters.
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Reference
[1]. Ultrasound: MedlinePlus Medical Test. Available from https://medlineplus.gov/lab-tests/sonogram/
