Streamlining Diagnosis with On-Site MSK Ultrasound Exams

At Panetta Physical Therapy, we understand the frustration of dealing with joint and muscle pain without a clear understanding of the source. That’s why we offer on-site MSK Ultrasound Exams (MSKUS – Musculoskeletal Ultrasound), a powerful tool for faster, more accurate diagnoses and efficient treatment planning.

What is a Musculoskeletal Ultrasound?

msk ultrasound exams

MSKUS is a painless, non-invasive imaging technique that uses sound waves to visualize the internal structures of your body, including muscles, tendons, ligaments, and joints. Unlike traditional X-rays, MSKUS provides real-time visualization, allowing our physical therapists to assess movement patterns and identify potential sources of pain in action.

How MSK Ultrasound Technology Works

Musculoskeletal Ultrasound (MSKUS) utilizes high-frequency sound waves to produce detailed images of the body’s soft tissues. This technology allows our therapists to see muscles, tendons, and ligaments in motion, providing a dynamic view that static images like X-rays cannot offer. MSKUS has evolved significantly over the years, with advances in ultrasound technology making it a more accessible and powerful diagnostic tool.

panetta on-site testing benefits

MSKUS applications for Joint and Muscle Pain Diagnosis

Shoulder pain diagnosis: 
    • Identify rotator cuff tears, tendonitis, bursitis, and other issues.
Knee pain diagnosis:
    • Diagnose ligament injuries, meniscus tears, and arthritis.
Elbow pain diagnosis
    • Assess tennis elbow, golfer’s elbow, and other conditions
Wrist pain diagnosis: 
    • Diagnose carpal tunnel syndrome, tendonitis, and ligament sprains.
Foot pain diagnosis
    • Identify plantar fasciitis, tendonitis, and joint problems.

In-Depth Comparison with Other Diagnostic Tools

Musculoskeletal Ultrasound vs. MRI:


  • Speed: MSKUS can be done in real-time during your visit, while MRIs often require scheduling and follow-up appointments.
  • Cost: MSKUS is generally more affordable compared to MRIs.
  • Accessibility: MSKUS equipment is more portable and accessible, allowing for on-site exams.


  • Detail: MRIs provide more detailed images of deeper structures, which can be necessary for certain diagnoses.
  • Scope: MSKUS is limited to soft tissues and superficial structures.

Preferred Scenarios: MSKUS is preferred for quick, real-time assessments of soft tissue injuries and dynamic movement evaluations.

MSKUS vs. CT Scans:


  • Radiation: MSK Ultrasounds do not use ionizing radiation, making them a safer option.
  • Real-Time Results: Unlike CT scans, MSKUS provides immediate feedback, which is crucial for dynamic assessments.


  • Detail: CT scans offer comprehensive images of both bones and soft tissues.
  • Scope: CT scans are better for detailed views of complex structures.

Preferred Scenarios: MSK Ultrasounds are ideal for evaluating soft tissue conditions and when avoiding radiation is a priority.

MSKUS vs. X-Rays:


  • Soft Tissue Visualization: MSKUS provides better visualization of soft tissues compared to X-rays, which are more suited for bone imaging.
  • Dynamic Imaging: A MSK Ultrasound can assess structures in motion, offering a more comprehensive view of joint and muscle function.


  • Bone Detail: X-rays are superior for viewing bone structures and detecting fractures.
  • Scope: X-rays cannot provide detailed images of soft tissues.

Preferred Scenarios: MSKUS is used for soft tissue injuries and functional assessments, while X-rays are used primarily for bone injuries.

Step-by-Step Guide to the MSKUS Process

What to Expect During an MSKUS Exam:

  • Initial Consultation: Your physical therapist will discuss your symptoms and medical history.
  • Preparation: Wear comfortable clothing that allows easy access to the area being examined. Avoid lotions or oils on the area.
  • The Exam: The therapist will apply a gel to the skin and use a handheld transducer to capture images. You may be asked to move the affected area to observe real-time motion.
  • Immediate Results: The images are viewed in real-time, allowing for immediate assessment and discussion of findings.
  • Post-Exam: Your therapist will review the results with you and discuss the next steps in your treatment plan.
Here’s an example of a quick assessment using MSKUS, performed by Dr. Therese Panetta-Young on a patient’s knee:

Benefits of MSKUS in Specific Conditions

Rotator Cuff Tears:

MSKUS can accurately detect tears in the rotator cuff, allowing for early intervention and targeted therapy to promote healing. This technology provides detailed images of the rotator cuff tendons, helping to differentiate between partial and full-thickness tears. Early detection through MSK Ultrasound enables timely physiotherapy, reducing pain and improving function. It also aids in monitoring the healing process and adjusting treatment plans as necessary. 

For patients considering surgical options, MSKUS can be used pre-operatively to assess the extent of the tear and post-operatively to evaluate the success of the repair.

Carpal Tunnel Syndrome:

MSKUS visualizes the median nerve and surrounding structures, helping diagnose carpal tunnel syndrome and guide treatment decisions. By providing real-time images, MSKUS allows for the assessment of nerve compression and swelling within the carpal tunnel. This precise imaging can identify the severity of the condition, which is critical for planning both conservative and surgical interventions. 

MSKUS can also be used to guide corticosteroid injections, ensuring accurate placement and increasing the effectiveness of the treatment. Additionally, it helps in evaluating the outcomes of surgical release procedures by assessing the nerve post-operatively.

Plantar Fasciitis:

With MSKUS, we can assess the thickness of the plantar fascia and identify inflammation, aiding in the development of an effective treatment plan. The high-resolution images provided by MSKUS can detect small tears, calcifications, and other abnormalities in the plantar fascia. This detailed assessment helps in tailoring specific treatment strategies, such as targeted stretching exercises, orthotics, and physical therapy modalities like ultrasound therapy. 

MSK Ultrasounds can also be used to guide and monitor the progress of extracorporeal shockwave therapy (ESWT) and other advanced treatments for chronic plantar fasciitis. By providing ongoing evaluations, MSKUS ensures that treatment adjustments are made promptly to enhance recovery and reduce the risk of recurrence.

Technological Advancements in MSKUS

Recent advancements in ultrasound technology have significantly enhanced the capabilities of MSKUS. Improvements in image resolution and portability have made MSK Ultrasounds a more effective diagnostic tool. High-definition ultrasound systems now offer enhanced contrast resolution, allowing for better visualization of soft tissue structures and subtle abnormalities.

The integration of elastography with MSKUS measures tissue stiffness, helping to differentiate between normal and pathological tissues, which is useful in diagnosing conditions such as tendinosis.

Future trends include the integration of artificial intelligence (AI) to assist in image interpretation. AI algorithms can quickly and accurately analyze ultrasound images, identifying patterns and anomalies that may be missed by the human eye, thereby enhancing diagnostic accuracy.

Additionally, the development of portable and wireless ultrasound devices is making MSKUS more accessible in a wider range of settings. Handheld devices that connect to smartphones and tablets are revolutionizing point-of-care diagnostics, particularly in remote or underserved areas.

These technological advancements are transforming MSKUS into a versatile and indispensable tool in musculoskeletal diagnostics, with expanding applications and improved patient care outcomes.

MSKUS questions and answers

Is MSKUS safe?

Yes, a MSK Ultrasound is a safe, non-invasive procedure that uses sound waves instead of radiation.

How long does an MSKUS exam take?

MSK Ultrasound exams typically take about 15-30 minutes, depending on the area being examined.

Do I need to prepare for an MSKUS exam?

There is minimal preparation needed. Wearing loose clothing and avoiding lotions on the area to be examined can help ensure a smooth process.

What conditions can MSKUS diagnose?

MSKUS can diagnose a variety of conditions including tendonitis, bursitis, rotator cuff tears, carpal tunnel syndrome, and plantar fasciitis.

Common Myths and Misconceptions about MSKUS

Myth: MSKUS is painful.
Fact: MSKUS is a painless procedure that uses sound waves to create images of soft tissues.

Myth: MSKUS is not as accurate as other imaging techniques.
Fact: MSK Ultrasounds provide highly accurate images of soft tissues and are particularly effective for real-time, dynamic assessments.

Myth: MSK Ultrasounds cannot be used for serious conditions.
Fact: MSKUS is a valuable tool for diagnosing a wide range of musculoskeletal conditions and is often used in conjunction with other diagnostic methods.

Research and Statistics

Research has shown that MSKUS is highly effective in diagnosing soft tissue injuries. Studies indicate that MSKUS has a high accuracy rate, comparable to MRI for many conditions. For example, a study published in the Journal of Physical Therapy Science found that MSKUS had an accuracy rate of over 90% for diagnosing rotator cuff tears.

Integration with Other Treatments

At Panetta Physical Therapy, MSKUS is integrated with various treatment modalities to provide comprehensive care. This includes using MSK Ultrasound findings to guide physical therapy exercises, perform ultrasound-guided injections, and develop personalized rehabilitation programs. Our multidisciplinary approach ensures that patients receive the most effective treatment based on their specific diagnosis.

In addition to our advanced diagnostic services, we also offer free physical therapy workshops for people with back pain, knee pain, shoulder pain, and peripheral neuropathy. These workshops are designed to provide valuable education and hands-on techniques to help manage and alleviate pain. Learn more and sign up for our workshops here.

Panetta Advantage

off-site vs on-side testing comparison

Our experienced physical therapists are highly skilled in conducting and interpreting MSK Ultrasound exams. With several conveniently located clinics across Long Island, we offer easy access to this advanced diagnostic tool.

Don’t let pain slow you down. Schedule an MSKUS appointment today and experience the benefits of on-site MSK Ultrasound examinations. Our team of skilled physical therapists is dedicated to helping you achieve optimal recovery and get back to feeling your best.

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Patient Testimonials

D Cav
D Cav
I cannot praise Panetta Physical Therapy enough! The staff is absolutely amazing. I've battled back pain for my entire life, and I honestly never believed I could find relief. However, thanks to Steve and the team, my life has taken a remarkable turn for the better. I am sincerely grateful for everything they've done for me and for the comprehensive care they provided. They didn't just address my specific problem; they took a holistic approach to my health. Today, I feel a million times better, and I owe it all to their expertise and dedication. If you're in need of physical therapy, don't hesitate to visit Panetta – you won't regret it!
Daniel Py
Daniel Py
This is a great place to go for physical therapy, very knowledgeable staff, and a nice large area to accommodate everyone who comes in. They do a good job having enough people for everyone who's doing therapy so you don't feel like you're being ignored. My only real complaint would be against whomever owns the business, in that there's fairly high turnover because they don't seem to pay their staff enough. This is sad to me, considering how skilled the therapists are, and how well they've treated me. I hope they see this and decide to improve things for all the great people who work there, before no one wants to anymore.
Robert Kohr
Robert Kohr
I came to Panetta unable to rsise my left arm. After working with Jen, she managed to loosen it up, restore function, and allow me to do pushups once again. Thanks for your hard work and making me feel better!
Gloria Portela
Gloria Portela
Philip Balcer is a great physical therapist. As my first time in therapy, he was excellent and I felt well taken care of. The entire staff was very friendly and I would absolutely go back again.
Cory Rabiea
Cory Rabiea
Highly recommended. Referred to Panetta PT through an acquaintance. Had a nagging hip/glute pain that would not let up for weeks and eventually decided to go to Panetta at their Glen Cove location. Steve was able to identify the underlying causes of my injury (hip tilt/unevenness causing tendonitis) and worked with me to correct my behavior and then rehab the injury. Three months later, and I am fully rehabbed and ready to resume my normal workout routine. Steve and Josh both were so instrumental in helping me develop new routines to get me on the mend, and I couldn't be more grateful for both of them.
Kaire Vung
Kaire Vung
Jennifer at Panetta Physical Therapy is absolutely an amazing physical therapist. Jennifer (and her team) took great care of me - she was so attentive to my injury and concerns, took the time to explain the treatments and provided me with home exercise and tool to help me make progress. I would not have recovered from my ankle surgery so quickly without Jennifer - THANK YOU! Last but not least, the facility is great and all the staff are super friendly and kind.
Spyro Markoulis
Spyro Markoulis
When I had my hip surgery I didn’t think I’d be anywhere near the level I was playing at. But thanks to the dedication to Phil, rich and all the crew, they really helped me get back to where I needed to be in order to continue my collegiate career. Still a long road to go but Philip and crew put their full effort into making you recover 100% with no setbacks and if it wasn’t for him I probably wouldn’t even be walking yet.
leila brooks
leila brooks
I was very impressed with your facility and caring staff. Dr. Phil is a proficient therapist. His patience and expertise are beyond compare. I am now pain free and able to get on with my life The interns Ari ,Carlos. Eddie and Constantine are very helpful and instructive. The front desk, Kimberly and Linda are always personable and informative I definitely will recommend Pannetta Physical Therapy.

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