[Value of ultrasound of the support and locomotor system--with special reference to radiation exposure and cost reduction].

In recent years, ultrasonic assessment of the locomotory system has become established both as a screening method in patients with chronic disorders and for evaluating acute injuries. Thanks to technical improvements to the equipment (use of high-frequency probes up to 20 MHz), ever smaller structures can be visualized. Ultrasonography can be carried out immediately following the clinical- and possibly radiological-assessment, by one and the same investigator, and requires little extra time. A bilateral examination in particular permits good evaluation of the extent of an injury and, with appropriate experience and good-quality equipment, an accurate assessment of the anatomical topography. Ultrasonography should now be used as the primary imaging method in the diagnosis of injuries to the following parts of the locomotory system, thus helping to minimize the number of expensive, and more invasive, diagnostic procedures: muscles and tendons, peri-articular soft tissue (in particular shoulder, knee and elbow joints), detection of intra-articular effusions, collections of fluid and, where applicable, ultrasonically guided puncture. In numerous other problems, too (postoperative complications, foreign bodies, fractures, osteomyelitis, soft tissue inflammation, etc.), ultrasound can deliver the first information. In this way, expensive diagnostic techniques can be reserved for special cases only, thus reducing costs. Furthermore, used as an adjunctive method, ultrasonography can reduce the number of diagnostic and follow-up X-rays in the case of injuries to the AC joint, shoulder dislocations, Hill-Sachs lesions, fractures in children, and for the detection of foreign bodies, again reducing radiation exposure and overall costs.