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Real time ultrasound applications 

As ultrasound imaging becomes accessible to physiotherapists, more applications are being developed including

Orthopaedic – assessment and monitoring of musculoskeletal conditions
Women’s health and continence

Haemophilia – assessing and monitoring bleeds
3-D assessment of muscle structure 
Transcapula scanning

Ultrasound is also now advocated for use in guiding invasive procedures and is now used to guide

Botox injections
Joint and soft tissue steroid injections
Shockwave therapy
Acupuncture needle placement.
EMG electrode placement

 Applications under development include

Assessment of neural mobility
Vascular assessment in pre manipulation screening
Use of contrast agents in the assessment of synovitis
Dynamic assessment of carpal instability


Real time ultrasound imaging is used to dynamically evaluate and quantify muscle activity during specific exercises and functional activities. Allowing the patient to observe muscle activity using ultrasound, while performing exercise is proving to be a potent biofeedback technique. These techniques are most often applied to the action of the deep abdominal and lumbar musculature.


Women’s health
With ultrasound imaging contractions of the pelvic floor muscles can be observed, along with their effect on the bladder, vagina and urethra. This enables the therapist to make a more effective assessment not only of muscle function, but also its impact on the continence mechanism.


Similarly, real time ultrasound can be used to assist in the clinical evaluation of musculoskeletal structures throughout the body. Ultrasound is particularly suited for assessing the morphology and behaviour of muscles, tendons, fascial planes and fluids along with their interaction with neighbouring structures. This is invaluable in the evaluation of adhesions, subluxations and effusions and has and obvious role in monitoring the response to treatment. Ultrasound is also the most appropriate method of image guidance for many therapeutic soft tissue injections, which are part of physiotherapy scope of practice in the UK.