Musculoskeletal Diagnostic Ultrasound and Intervention


Ultrasound is an imaging examination which utilizes sound waves to create an image. A hand-held device, called a probe, is covered with gel to help the sound waves travel through the skin. The probe is then placed on the skin and sends sound waves into the adjacent body part. The sound waves return to the probe and create a real-time image of that body part. In the musculoskeletal system, imaged structures include many tendons, ligaments, muscles, and joints. MSK US is often complementary to other imaging examinations (e.g., radiographs, CT, MRI).


Diagnostic MSK US is a safe way to examine many joints and overlying structures. A diagnostic examination typically lasts for 15-30 minutes, however if an US directed therapeutic procedure is performed during the same session, additional time will be required.

Some benefits of MSK US include:

  1. Safe; sound waves, not ionizing radiation, are used
  2. Painless
  3. Noninvasive*
  4. Often can provide an alternative to MRI for those individuals who cannot undergo MRI for any reason, such as the presence of certain non-MRI compatible devices in the body

* If there is a procedure that can help alleviate your symptoms, it can often be done during the same appointment rather than having you come back for a second visit.


It is important to note that MSK US is complementary to other imaging modalities (radiographs, CT, MRI). Many MSK US exams have a dynamic component which can add valuable information to the other static imaging exams. In addition, ultrasound can be a reasonable alternative test for patients who cannot or who prefer to not have an MRI (such as patient claustrophobia or the presence of non-MRI compatible implanted devices).

Why choose Duke Radiology for your patient’s MSK US?

We are committed to accommodating your patients in our Duke North Hospital clinic as soon as possible. We routinely save our images on our PACS, allowing for optimal comparison to prior or future imaging tests. This can be of particular value when trying to compare an MSK US to an imaging test of a different modality such as a plain film or MRI. As radiologists, our study documentation is routine and comprehensive, and we provide a detailed report of findings (and at times recommendations) which are associated with the saved images.

Some examples of when Diagnostic MSK US can be helpful:

  • Tendon tears or tendinitis
  • Muscle tears, masses, or fluid collections
  • Ligaments tears or sprains
  • Presence of joint or bursal fluid, +/- accompanying inflammation
  • Early changes of inflammatory arthritis
  • Certain nerve entrapments; cubital and carpal tunnel
  • Presence of ganglion cysts
  • Presence of foreign bodies in the soft tissues

Provide image guidance for various minimally invasive therapeutic interventions for the above and more


We strive to make ordering this examination as streamlined as possible within EPIC.

For Duke patients and providers please place an order in EPIC utilizing one of the following:

US extremity nonvascular LEFT complete (IMG7658; CPT 76881)
US extremity nonvascular RIGHT complete (IMG7659; CPT 76881)
Please confirm the appropriate body part/joint, laterality, and “treat as appropriate” within the comments section of the EPIC order (if the necessity of a therapeutic intervention is anticipated)

Once ordered in EPIC please have someone in your office call (919)-684-7431 and speak with Janet who schedules these examinations at Duke North Ultrasound.

For patients and providers outside of Duke please contact the Duke Scheduling Hub at 684-7999, to obtain a Duke medical record number and order request. Once ordered please have someone in your office call (919)-684-7431 and speak with Janet who schedules these examinations at Duke North Ultrasound.