Ultrasound
LITERATURE REVIEW
The Utility of Musculoskeletal
Ultrasound in Rehabilitation Settings
ABSTRACT
O
¨
zçakar L, Çarlı AB, Tok F, Tekin L, Akkaya N, Kara M: The utility of
musculoskeletal ultrasound in rehabilitation settings. Am J Phys Med Rehabil
2013;92:00Y00.
Aside from its prompt use in musculoskeletal injuries (sports lesions, degenerative/
inflammatory joint disorders, and peripheral nerve pathologies), ultrasonographic
imaging can be used quite conveniently in various types of rehabilitation conditions
as well. If used in a rehabilitation setting, ultrasound can significantly contribute to the
diagnostic/therapeutic algorithm of rehabilitation patients. Accordingly, in this article,
the authors focus on the diagnostic/interventional utility of ultrasound particularly for
shoulder problems, overuse injuries of wheelchair users, heterotopic ossification,
amputee follow-up, peripheral nerve and botulinum toxin injections, and diaphragm
imaging/electromyography.
Key Words: Rehabilitation, Ultrasound, Shoulder, Wheelchair, Heterotopic Ossification,
Amputation, Peripheral Nerve, Botulinum Toxin, Diaphragm
M usculoskeletal ultrasound (US) has already taken its place in the daily practice
of physical and rehabilitation physicians because of its several advantages, that is,
convenient, inexpensive, does not contain radiation, and provides dynamic assess-
ment and guidance during interventions.
1
On the other hand, to the authors’ best
notice, it is much more used by physiatrists who are mainly dealing with muscu-
loskeletal medicine (sports injuries, degenerative/inflammatory joint disorders,
and peripheral nerve pathologies) rather than rehabilitation medicine.
2,3
Accord-
ingly, to increase the awareness of relevant physiatrists and/or physicians with
regard to the possible role of musculoskeletal US in their clinical practice, in this
article, the authors aimed to highlight the potential utility of US in certain clinical
scenarios often encountered in rehabilitation settings.
HEMIPLEGIC SHOULDER PAIN
In patients with hemiplegia, shoulder pain may develop from a variety of
factors including shoulder subluxation, spasticity, impingement, soft tissue
trauma, rotator cuff tears, adhesive capsulitis, bicipital tendonitis, and shoulder
hand syndrome.
4Y10
Shoulder subluxation occurs during the flaccid stage after stroke, and it is
among the most common causes of shoulder pain in patients with hemiplegia.
11
In
Authors:
Levent O
¨
zc ¸akar, MD
Alparslan Bayram C ¸ arlı, MD
Fatih Tok, MD
Levent Tekin, MD
Nuray Akkaya, MD
Murat Kara, MD
Affiliations:
From the Department of Physical and
Rehabilitation Medicine, Hacettepe
University Medical School, Ankara,
Turkey (LO
¨
); Physical and
Rehabilitation Medicine Clinic,
Gu ¨ lhane Military Academy Haydarpas ¸a
Training Hospital, Istanbul, Turkey
(ABC ¸ , LT); Physical and Rehabilitation
Medicine Clinic, Iskenderun Military
Hospital, Iskenderun, Turkey (FT);
Department of Physical and
Rehabilitation Medicine, Pamukkale
University Medical School, Denizli,
Turkey (NA); and Ankara Physical
and Rehabilitation Medicine Training
and Research Hospital, Ankara,
Turkey (MK).
Correspondence:
All correspondence and requests for
reprints should be addressed to Levent
O
¨
zc ¸akar, MD, Hacettepe U
¨
niversitesi
Tıp Faku ¨ ltesi Hastaneleri Zemin Kat
FTR AD, Sihhiye, Ankara, Turkey.
Disclosures:
Financial disclosure statements have
been obtained, and no conflicts of
interest have been reported by the
authors or by any individuals in control
of the content of this article.
0894-9115/13/9207-0000/0
American Journal of Physical
Medicine & Rehabilitation
Copyright * 2013 by Lippincott
Williams & Wilkins
DOI: 10.1097/PHM.0b013e3182971269
www.ajpmr.com Musculoskeletal Ultrasound in Rehabilitation 1
Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.