Soft Tissue U/S

Diagnostic soft tissue ultrasound is very useful in the emergency department. Here, we commonly use 2 applications:

• soft tissue infection - cellulitis / abscesses
• foreign body localization

Preparation and scan technique

• All soft tissue ultrasound is performed with the high frequency linear transducer. Use the small parts setting or the nerve setting.
• Patient is in position of comfort. Expose the area required for scanning.
• Use a water bath if the area of interest is very superficial. E.g. fill a latex glove with water, place it over the area of interest, and scan the area with the probe over the water-filled glove.
• Remember to scan through the area, looking proximal, distal, medial and lateral. Adjust depth settings to see the area of interest in detail.
• Gentle pressure with the ultrasound probe can demonstrate fluctuancy if needed. Be mindful if it is an abscess and is painful.
• Color doppler is helpful to assess vascular structures, and may help to distinguish lymph nodes (which sometimes have a hypoechoic appearance i.e. cystic)

Watch a comprehensive video tutorial on MSK ultrasound here: