Understanding Musculoskeletal and Intraoperative Ultrasound Applications

Ultrasound Applications, Ultrasound Probes and Transducers, Understanding Ultrasounds - Tue Oct 23 2018


Part of our “Understanding Ultrasound” series includes understanding and discussing various ultrasound applications; what they are used to diagnose, probes that specialize in the particular application, and the best ultrasound machines to employ – whether it be for a specialist or general diagnostician. This particular article will discuss musculoskeletal and intraoperative ultrasound applications.

Musculoskeletal Ultrasound:


Musculoskeletal ultrasound is using high frequency ultrasound waves (which are harmless and non-invasive) to diagnose and examine muscle tissue for sprains, tears and other potential damage. High frequency sound waves are specifically employed due to the nature of ultrasound waves; the lower the frequency the deeper the penetration, and the higher the frequency the more shallow. Musculoskeletal ultrasounds are considered general ultrasounds due to the fact that they are not limited to one location (like abdominal ultrasounds). Rather, any body part that contains muscle tissue can be diagnosed with a musculoskeletal ultrasound.

Ultrasound Probes: 

There are two types of ultrasound probes that specialize in musculoskeletal applications: Wideband linear array probes and hockey stick linear array probes.

Wideband linear array transducers are recognizable by their long straight line lens on the face of the probe. They all have high frequency ranges, which allows them to project surface and shallow ultrasound photos.

Hockey Stick linear array transducers have earned their name based on their appearance; that of a hockey stick. On the bottom of the stick is the probe lens – also shaped in a straight thin line. These probes, like their Wideband cousins, have very high frequency ranges in order to allow shallow imaging.

Musculoskeletal Ultrasound Machines:

Many musculoskeletal ultrasound machines can also project general ultrasound images. Almost every ultrasound machine that can project musculoskeletal images can also project small part images (which include thyroid, testicular and breast applications).

Some of A.M.E. Ultrasound’s top recommended ultrasound machines include the GE Logiq E portable ultrasound system, GE Logiq E9 ultrasound machine, the Samsung Accuvix A30, and the Philips Epiq 5 ultrasound systems. These systems all specialize in general images, and are acclaimed by engineers and diagnosticians alike for their proficiency in musculoskeletal images.

i12l 12l probes

Linear Array on the right, Hockey Stick probe on the left

Intraoperative Ultrasound:


Intraoperative ultrasound application is the employment of ultrasound technology during surgery. Diagnosticians and sonographers examine the ultrasound images as the surgery occurs, detecting tumors, clots, or other potentially hazardous problems. It is most frequently employed during spinal surgery, but is also used during abdominal and other types of surgery.

Ultrasound Probes:

There are a few types of ultrasound transducers that are capable of producing intraoperative ultrasound images. These probes, although commonly referred to as “intraoperative” probes, are recognizable by a few telltale features:

“T” probes, not to be confused with TEE (transesophageal) transducers, are one type of probe that is capable of performing intraoperative ultrasounds. These probes are shaped like a 3D “T” and have a thin linear shape on the lens. These probes tend to be able to perform the same functions as Wideband Linear and Hockey Stick array probes, and have a high frequency range as well.

Some specific Hockey Stick array probes are also capable of producing intraoperative applications, including the GE i12L hockey stick probe, the Sonosite SLAx and the HSL25x hockey stick probes.

Intraoperative Ultrasound Machines:

A.M.E Ultrasounds recommends a variety of both portable and stationary ultrasound machines that provide the best possible images for Intraoperative applications for the best prices. In terms of portable ultrasound systems, the Sonosite Edge II, Philips CX50, and the GE Logiqbook XP are all spectacular systems that range from premier to entry level quality.

Some highly recommended stationary systems include the Philips Sparq, the Siemens Acuson X300, and the GE Vivid E9 ultrasound machines. The Sparq specializes in emergency medicine, the X300 is a shared service system, and the Vivid E9 specializes in cardio-vascular applications, but is extremely versatile and can project quality images for many other applications.


Mindray "T" probe
“T” intraoperative linear array probe

Similarities in Applications:

There are a few commonalities between the musculoskeletal application and intraoperative application; probes, some machines that are capable of providing images for both applications, and even the type of ultrasound scan that occurs.


The crossover in ultrasound probes when it comes to these two applications is the Hockey Stick linear array transducer. Although not every Hockey Stick probe is capable of producing intraoperative applications, there are more than a few that are capable of producing images for both intraoperative and musculoskeletal applications. These probes tend to be exceptionally versatile, and can also provide images for small parts and vascular applications.

Ultrasound Machines:

There are many ultrasound machines that are capable of translating images for these two applications. There are the popular shared service systems, such as the GE Logiq E9, or the Sonosite Edge II portable ultrasound machine. There are also emergency medicine machines, such as the Philips Sparq, that specialize in these applications and not much else (vascular and small parts applications often included).

Ultrasound Scans:

Both of these applications are considered more superficial or surface scans. Musculoskeletal ultrasounds, examining muscles and tissue that are closer to the surface of the body, and intraoperative ultrasounds, examining body parts during surgical procedures, do not need to penetrate very far. Therefore, these probes have a higher frequency range than any other type of ultrasound transducer. Again, the higher the frequency range, the less deep the penetration.


Philips Sparq ultrasound machine

Ultrasound Safety:

There is always the concern, particularly when it comes to medical equipment, regarding the safety of the devices and the potential side effects that occur as a result of employing these machines.

It is important to know that ultrasound machines are known to be completely harmless. They function through the utilization of sound waves emitting from the probe or transducer. These sound waves are then translated into images by the ultrasound machine or system. There is no need to fear when using ultrasound machines – it is a quick, easy and efficient way to diagnose and help determine a patient’s ails.


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