title: Musculoskeletal sonography technique: focused versus comprehensive evaluation.
abstract: OBJECTIVE
  This article evaluates the utility of performing a focused musculoskeletal sonography examination on the basis of patients' presenting complaints.
  
  
  METHODS
  Six hundred two patients evaluated over 6 months were scanned using a routine protocol. At the completion of the routine examination, each patient was asked to indicate a focal point of discomfort and, if present, was rescanned over the area of discomfort. Patients were classified in one of five categories depending on whether there was a focal point of discomfort and the presence or absence of an underlying sonographic abnormality.
  
  
  RESULTS
  Eighty-three percent of the 602 patients had a sonographically detectable abnormality, 2.2% of whom had an abnormality not detectable by routine protocol-based scanning. The more peripheral the body part, the more likely that abnormalities detected by sonography correlated with focal symptoms: 81% in the wrist and hand and 73% in the ankle and foot, compared with the more central body parts of 15% in the shoulder and 31% in the hip. Chi-square analysis showed a significant association between the body part scanned and a detectable abnormality (p < 0.0001).
  
  
  CONCLUSIONS
  Although a focused examination of the distal extremities correlated with an abnormality in most cases, a protocol-based approach ensured identifying 97.4% of the symptomatic abnormalities. The addition of a focused examination to an examination by protocol further increased the identification of abnormalities.
authors: Department of Radiology, University of Michigan Hospitals, 1500 E Medical Center Dr., TC2910, Ann Arbor, MI 48109, USA.
authors: David A
authors: DA
authors: Jamadar
authors: Jon A
authors: JA
authors: Jacobson
authors: Elaine M
authors: EM
authors: Caoili
authors: Tracy A
authors: TA
authors: Boon
authors: Qian
authors: Q
authors: Dong
authors: Yoav
authors: Y
authors: Morag
authors: Gandikota
authors: G
authors: Girish
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005121:Extremities / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007596:Joints / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000002:abnormalities / Q000000981:diagnostic imaging; D009139:Musculoskeletal Abnormalities / Q000000981:diagnostic imaging; D009140:Musculoskeletal Diseases / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013708:Tendon Injuries / Q000000981:diagnostic imaging; D014463:Ultrasonography