Bradley - atlas of musculoskeletal ultrasound anatomy

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Atlas of musculoskeletal ultrasound anatomy

Atlas of musculoskeletal ultrasound anatomy
Dr Mike Bradley,
Consultant Radiologist, North Bristol NHS Trust, Honorary Senior Lecturer, University of Bristol


Dr Paul O’Donnell,


Consultant Radiologist, Royal National Orthopaedic Hospital, Stanmore, Middlesex



cambridge university pressCambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge cb2 2ru, UK Published in the United States of America by Cambridge University Press, New York Information on this title: © Greenwich Medical Media Limited 2002 This publication is in copyright. Subject to statutory exceptionand to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published in print format 2004 isbn-13 isbn-10 isbn-13 isbn-10 978-0-511-19612-6 eBook (NetLibrary) 0-511-19612-1 eBook (NetLibrary) 978-1-841-10118-7 paperback 1-841-10118-4 paperback

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Preface – technology introduction Echogenicity of tissues xi vii ix Principles and pitfalls of musculoskeletal ultrasound


1Supraclavicular fossa 2 Infraclavicular fossa 8 Sternoclavicular joint 10 Chest wall 12 Axilla 22

Upper limb
Shoulder 28 Upper arm 46 Elbow 50 Forearm 72 Wrist 82 Hand 96


Abdomen and pelvis
Anterior wall 116 Posterior wall 126 Groin 134 Hip 146


Lower limb
Thigh 172 Knee 184 Calf 214 Ankle 224 Foot 244



Preface – technology introduction
The images in the current textwere achieved using an ATL HDI 5000 SonoCT ultrasound system (Advanced Technology Laboratories, Bothwell, WA) coupled with an L12–5 MHz footprint linear array transducer. A stand-off pad was not used, but liberal amounts of coupling gel was applied. Most of the images displayed were obtained using ATL’s patented SonoCT real-time compound imaging technology. This technology is distinct fromconventional ultrasound in that it obtains images from multiple lines of sight. In real-time compounding, ultrasound beams are steered from up to nine lines of sight and are combined into a single image at real-time frame rates. This allows all structures to be scanned at a plane that is at or close to 90° to one or more of the scan lines. It is distinct from other compounding methods, in that it usescomputed transmit-and-receive functions to form a compound image in real time. This technology can dramatically suppress or eliminate many routine problems that degrade ultrasound images, such as noise, speckle, clutter and image artefacts. In addition, contrast resolution is enhanced improving diagnostic confidence. Recently, ATL have introduced SonoCT Imaging achieving a breakthrough in panoramicimage quality. ATL uses patented pattern recognition technology, instead of matching pixels along the edge of an image to generate a panoramic appearance. Panoramic SonoCT relies on processing tissue patterns captured from a region of interest. This real-time pattern recognition method makes it easier and faster to perform panoramic scanning because it is less dependent on the user maintaining asteady and smooth sweep. It also enables the user to easily reverse direction without restarting a panoramic scan.

Preface – technology introduction vii

Principles and pitfalls of musculoskeletal ultrasound
High resolution – best results are obtained using a high frequency linear probe on a matched ultrasound system. Power Doppler is often helpful for pathological diagnosis as well in the...
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