Ultrasound examination in Vienna
Tendons, ligaments, bursae and nerves can be viewed directly on ultrasound — and while they are moving. With me, the examination is part of the appointment rather than a second trip to another address. It is a method of examination, not a treatment.
In short
Ultrasound (sonography) is a diagnostic procedure. It shows soft tissue: tendons, tendon sheaths, ligaments, bursae, muscles, nerves and fluid in the joint. It sees bone only at its surface and does not look inside the joint — that requires an X-ray or an MRI, which I arrange outside the building. Its great advantage lies in examining during movement and in comparison with the healthy side. It is available in the practice straight away, involves no radiation and also guides the needle during an injection.
A diagnostic procedure, not a therapy
This page is listed under the treatments, but it does not describe a treatment procedure. Ultrasound treats nothing. It establishes the findings: it shows which structure is irritated, thickened, torn or displaced — and it guides the needle when an injection follows. What actually treats is set out in the overview of the conservative procedures.
What ultrasound shows
The transducer sends high-frequency sound waves into the tissue and measures what comes back. It renders soft tissue in fine resolution — precisely those structures that cause most complaints at the shoulder, elbow and hand:
- Tendons — thickening, fraying, a partial tear or a full-thickness tear, for instance at the rotator cuff. More on the rotator cuff tear.
- Calcium deposits in a tendon, including their position and extent — the basis for treating calcific tendinitis.
- Bursae — thickening and fluid as signs of irritation.
- Tendon sheaths — a rim of fluid and thickening of the pulley, for instance with trigger finger.
- Ligaments — whether they are continuous and whether the joint opens up under tension.
- Nerves — their course and changes in calibre, for instance of the median nerve in the carpal tunnel or of the ulnar nerve at the elbow.
- Effusion (fluid) in the joint, as well as irregularities at the surface of the bone.
What it does not show
The other side matters just as much. Sound does not pass through bone. Everything that lies behind the surface of the bone stays hidden: the inside of the bone, the course of a fracture at depth and the cartilage in those parts of the joint that cannot be seen from outside. The labrum (joint lip) at the shoulder and the ligaments inside the joint also largely escape it.
Other methods exist for that. An X-ray shows bone, alignment and the joint space. An MRI shows cartilage, bone marrow and the structures inside the joint. I arrange both when the findings call for it; I do not have them in the building. Ultrasound narrows down beforehand what remains to be clarified — so further imaging is requested in a targeted way rather than speculatively.
The advantage: examination during movement
The real benefit only becomes apparent once the arm moves. X-ray and MRI capture a single moment; ultrasound keeps pace with the movement. I see how the tendon glides under the roof of the shoulder and whether it impinges as it does so, how the flexor tendon snags at the pulley, whether a ligament gives way under tension, and whether a torn tendon pulls back when the muscle is tensed. Some findings only arise with movement at all — at rest they would look unremarkable.
Added to this is the comparison with the healthy side. It is right alongside and provides the benchmark for what is normal for you. I do not examine in silence: you watch the image with me, and I show you the structure in question.
Available straight away, without radiation
The ultrasound machine is in my practice rooms. Examination and findings fall within the same appointment — you neither have to travel to another address nor wait for a second appointment. No X-ray radiation is produced, no contrast medium is needed, and the examination can be repeated as often as required during follow-up. You do not need to prepare anything; a gel on the skin is enough, and the transducer is simply placed on it.
Ultrasound guides the needle
Its second use is in treatment. During an injection I follow the needle in the image from the point of entry to the target and see where its tip lies; more on this on the page about ultrasound-guided injection. The same applies when platelet-rich plasma is placed — see PRP therapy — and when I determine the target point before focused shockwave therapy.
My practice is a private practice, in Austria a Wahlarztordination. I do not bill any public health insurer directly; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. After the examination, I decide together with you what ultrasound can clarify in your case and which further imaging makes sense.
Frequently asked
Frequently asked questions about ultrasound
No. Ultrasound is a diagnostic procedure: it is used to establish the findings, and it does not treat anything. In my practice it has two tasks — it shows which structure is affected, and it guides the needle if an injection is given afterwards.
Soft tissue: tendons with thickening, fraying or a tear, calcium deposits in a tendon, irritated bursae, tendon sheaths, ligaments, muscles and nerves. Ultrasound also shows fluid in the joint and irregularities at the surface of the bone. These are precisely the structures that cause most complaints at the elbow, shoulder and hand.
Sound does not pass through bone. The inside of the bone, the course of a fracture at depth and the cartilage in the parts of the joint that cannot be seen stay hidden; the labrum at the shoulder and the ligaments inside the joint also largely escape it. For those, an X-ray or an MRI is needed.
No, the procedures show different things. With tendons, bursae and nerves, ultrasound often gets a long way, and it shows them in movement; X-ray and MRI capture a single moment. Where cartilage, bone marrow or structures inside the joint are concerned, I arrange an MRI outside the building.
It means that I examine while the arm is moving. I see how the tendon glides under the roof of the shoulder, how the flexor tendon snags at the pulley, or whether a ligament gives way under tension. Some findings only arise with movement; on a still image they would look unremarkable.
No X-ray radiation is produced, and no contrast medium is given. The transducer is placed on the skin with gel; the gel feels cool, and nothing more happens. Over a spot that is very sensitive to pressure, placing the transducer can hurt briefly — let me know if it does, and I will scan more gently.
No. You do not need to fast, and you do not need a referral. Clothing that allows the shoulder and arm to be uncovered is practical. Please bring with you whatever previous reports and images you have — doctors' letters and X-ray, CT and MRI images.
It shows where the tip of the needle lies. I follow the needle in the image from the point of entry to the target and see how the medication spreads. That way it reaches the structure in question, and whatever lies next to it is spared. The same applies when platelet-rich plasma is placed.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
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Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.