Table Of ContentSECOND EDITION
SECOND EDITION
Griffith
Griffith
LEE | HUNG | NG
LEE | HUNG | NG
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SECOND EDITION
James F. Griffith, MD, MRCP, FRCR
Professor
Department of Imaging and Interventional Radiology
The Chinese University of Hong Kong
Hong Kong (SAR), China
Ryan K. L. Lee, MBChB, FRCR, FHKCR, FHKAM (Radiology)
Clinical Assistant Professor (Honorary)
Department of Imaging and Interventional Radiology
The Chinese University of Hong Kong
Hong Kong (SAR), China
Esther H. Y. Hung, MBChB, FRCR, FHKCR, FHKAM (Radiology)
Clinical Associate Professor (Honorary)
Department of Imaging and Interventional Radiology
The Chinese University of Hong Kong
Hong Kong (SAR), China
Alex W. H. Ng, MBChB, FRCR, FHKCR, FHKAM (Radiology)
Clinical Associate Professor (Honorary)
Department of Imaging and Interventional Radiology
The Chinese University of Hong Kong
Hong Kong (SAR), China
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DIAGNOSTIC ULTRASOUND: MUSCULOSKELETAL, SECOND EDITION ISBN: 978-0-323-57013-8
Copyright © 2019 by Elsevier. All rights reserved.
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Dedication
To Clara, Isobel and Olivia, Mum, Dad, and all my siblings.
For the very best of times, thank you.
JFG
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Additional
Contributing Authors
Jill M. Abrigo, MD
Gregory E. Antonio, MD, DRANZCR, FHKCR
Stella Sin Yee Ho, RDMS, RVT, PhD
Eric K. H. Liu, PhD, RDMS
Eugene McNally, FRCR, FRCPI
Karen Partington, MRCS, FRCR
Bhawan K. Paunipagar, MBBS, MD, DNB
K. T. Wong, MBChB, FRCR
Jade Wong-You-Cheong, MBChB, MRCP, FRCR
Paula J. Woodward, MD
Philip Yoong, FRCR
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Preface
I have no doubt whatsoever that musculoskeletal ultrasound will become the most influential
imaging modality in the world of musculoskeletal disease diagnosis, treatment, and monitoring.
It is already well on its way to becoming that megastar. Those musculoskeletal conditions best
imaged by musculoskeletal ultrasound and those best examined by other modalities, such as
MR, CT, or radiography, are now quite clearly understood. The vast majority of musculoskeletal
conditions outside of deeper joint structures are accessible to adequate evaluation by
musculoskeletal ultrasound. Going forward, this range of clinical application is not likely to
significantly expand, but the clarity with which these conditions will be seen will no doubt
improve even further. Since the emergence of high-resolution transducers in the early 90s,
ultrasound image resolution has improved beyond recognition. High musculoskeletal image
quality is now achievable on all modern mid- to high-end ultrasound machines.
Ultrasound is different from other modalities in that you alone are the master of your destiny
in realizing a high-quality ultrasound examination, acquiring readily understandable images,
and arriving at the correct diagnosis. Similar to other imaging modalities, any diagnosis
is formulated, not just on a single imaging characteristic, but also on myriad imaging signs
evaluated within a particular clinical context. All ultrasound experts will tell you that ultrasound
imaging is a lifelong learning skill. Each time you examine a patient with ultrasound, you should
finish that examination a teeny weeny bit more skilled than you were before you began it.
No other imaging modality seems to afford this capacity for continual improvement quite as
much as ultrasound. This requires a pedantic approach armed with a thorough knowledge
of ultrasound anatomy, a meticulous ultrasound technique, a clear understanding of the
pertinent ultrasound findings, awareness of the most likely diagnosis, the mitigating features,
and the potential differential diagnoses. Each of these aspects has been specifically addressed
in this book, the 2nd edition of Diagnostic Ultrasound: Musculoskeletal.
Anatomy, with a particular emphasis on anatomy relevant to musculoskeletal ultrasound, is
comprehensively covered in the 1st section. The next section, Technique, discusses an overall
approach to musculoskeletal ultrasound and artifacts, followed by a detailed account of how
to undertake a comprehensive examination of the main joints, emphasizing those areas most
frequently examined by musculoskeletal ultrasound. Key elements to writing an ultrasound
report are also addressed. The 3rd section, Diagnoses, looks at specific musculoskeletal
conditions, the range of potential ultrasound appearances encountered, and the key facts
required to make a correct diagnosis. The 4th section, Differential Diagnoses, looks at
clinical ultrasound from a different perspective, outlining those diagnoses to be considered
when faced with a particular ultrasound scenario, such as a hypoechoic muscle mass or a
hypervascular subcutaneous mass. The 5th section addresses the fast-growing influence and
range of ultrasound-guided interventional techniques in treatment and diagnosis. The overall
content of the book, particularly the latter 4 sections, has been updated by at least 20% from
the 1st edition, which was published in 2013.
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A huge thank you goes out to Rebecca Bluth, Karen E. Concannon, and Rich Coombs at
Elsevier for your help in putting this book together. The email equivalent of neural strain
was understandably evident on many occasions over the past 18 months. Despite this, and
having never met in person, we have nevertheless, I feel, become good friends and I remain
in awe of your professional attitude, good nature, and dedication. A big, big thank you for
your efforts.
A huge thank you also goes out to my close colleagues, Alex Ng, Ryan Lee, Esther Hung,
and Cina Tong, as well as all the staff in the Department of Imaging and Interventional
Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong. Your dedication
to maintaining a high standard of musculoskeletal ultrasound is admirable.
And to you, the readers, I do hope you enjoy this book and find it helpful in your daily
practice. Please do persevere with musculoskeletal ultrasound. 100% guaranteed, you will
not be disappointed.
James F. Griffith, MD, MRCP, FRCR
Professor
Department of Imaging and Interventional Radiology
The Chinese University of Hong Kong
Hong Kong (SAR), China
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