Musculoskeletal Ultrasound

Ultrasound is a powerful diagnostic tool for the imaging evaluation of various musculoskeletal and rheumatic disorders and a guidance tool for performance of joint injections and aspirations. Current ultrasound technique allows not only to visualize the anatomy of joints, tendons, and ligaments but also to assess the activity of inflammation at its early stages when other approaches fail.

Dr. Shikhman is one of the first rheumatologists in the United States to use various ultrasound techniques in everyday rheumatology practice.

Currently, musculoskeletal ultrasound is used in our clinic for the following indications:
•    assessment of gross joint anatomy (synovial lining, tendons, ligaments, muscles, nerves, menisci, etc.)
•    assessment of joint inflammation
•    detection of joint fluid
•    assessment of rheumatoid arthritis activity
•    assessment of ankylosing spondylitis / reactive arthritis / psoriatic arthritis activity
•    assessment of nerve entrapment syndromes (carpal tunnel syndrome, tarsal tunnel syndrome, etc)
•    assessment of therapeutic responses
•    needle guidance of joint aspirations and injections
•    needle guidance for soft tissue injections and nerve blocks
•    needle guidance for epidural injections
•    needle guidance for prolotherapy

Our clinic is equipped with high resolution ultrasound allowing us to generate 2D and 3D gray scale images as well as images of the joint and soft tissues blood flow (Doppler technique).

To find more information about our use of ultrasound, call us at (858) 794-9192 or send us an e-mail at