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Case Reports
. 2024 Nov 11;16(11):e73453.
doi: 10.7759/cureus.73453. eCollection 2024 Nov.

Advanced Visualization of Musculoskeletal Pathologies Using MV-Flow Ultrasound: A Case Series

Hye-Jin Y Clark  1 , Clayton Walker  2 , Eugene Y Roh  3
Affiliations
Case Reports

Advanced Visualization of Musculoskeletal Pathologies Using MV-Flow Ultrasound: A Case Series

Hye-Jin Y Clark et al. Cureus. .

Abstract

The blood flow-detecting mode of ultrasound images can be beneficial for assessing the degree of inflammation among various musculoskeletal conditions and their recovery. Power Doppler (PD) ultrasound is typically used for blood flow, but its limitations in detecting low-velocity blood flow hinder comprehensive assessment. The microvascular flow tool (MV-Flow) from the Samsung V7 and RS85 ultrasound systems (Samsung Co., Seoul, South Korea), offers advanced visualization of microcirculatory and slow-flow connections that PD and Color Doppler (CD) cannot detect. This case series highlights the novel application of MV-Flow in diagnosing sports medicine-related conditions, specifically tendinopathy, demonstrating its utility even when magnetic resonance imaging (MRI) and conventional ultrasound fail to reveal abnormalities.

Keywords: diagnostic musculoskeletal ultrasound; microcirculation and inflammation; microvascular ultrasound; musculoskeletal imaging; mv flow ultrasound; sports related injuries; tendinopathy pain.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Eugene Roh declare(s) non-financial support from Stanford University. Hospital Point of Care Committee member. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Coronal STIR MRI view of a 17-year-old man showing UCL partial tear and mild osseous irregularity at the attachment of the UCL, which is mildly thickened anteriorly with minimal edema.
Short T2 inversion recovery (STIR); magnetic resonance imaging (MRI); arrows: ulnar collateral ligament (UCL).
Figure 2
Figure 2. Long-axis view of the UCL with the color Doppler tool not visualizing any hyperemia.
Arrows: Ulnar collateral ligament (UCL).
Figure 3
Figure 3. Long-axis view of UCL with MV-Flow tool showing hyperemia within the ligament.
Arrows: Ulnar collateral ligament (UCL).
Figure 4
Figure 4. Mild quadriceps tendinosis in a 21-year-old man. Axial proton density fat-suppressed MRI of the knee showing mild distal quadriceps tendinopathy.
Arrows: Quadriceps tendon.
Figure 5
Figure 5. Short-axis view of the distal quadriceps tendon with color Doppler showing no hyperemia within the tendon.
Arrows: Quadriceps tendon.
Figure 6
Figure 6. Short-axis view of the distal quadriceps tendon with MV-Flow tool showing hyperemia within the tendon.
Arrows: Quadriceps tendon.
Figure 7
Figure 7. Sagittal fat-suppressed T2 MRI of the ankle showing mild Achilles tendinosis with an interstitial tear.
Arrows: Achilles tendon.
Figure 8
Figure 8. Achilles tendinosis in a 57-year-old man. Long-axis view of Achilles tendon with MV-Flow showing hyperemia within the tendon.
Arrows: Achilles tendon.
Figure 9
Figure 9. Long-axis view of the Achilles tendon with the color Doppler tool showing no hyperemia within the tendon.
Arrows: Achilles tendon.
Figure 10
Figure 10. Tendinosis of the common extensor tendon at the lateral epicondyle attachment in a 53-year-old man. Coronal proton density fat-suppressed MRI of the elbow showing a low-grade partial thickness tear of the proximal common extensor tendon at the lateral epicondyle attachment.
Arrows: Common extensor tendon.
Figure 11
Figure 11. Long-axis view of the common extensor tendon with MV-Flow showing moderate hyperemia within the tendon.
Arrows: Common extensor tendon.
Figure 12
Figure 12. Long-axis view of the common extensor tendon with the color Doppler tool showing mild hyperemia within the tendon.
Arrows: Common extensor tendon.
Figure 13
Figure 13. Tendinosis of the proximal patellar tendon in a 22-year-old man. Long-axis view of the patellar tendon with Color Doppler tool showing no hyperemia within the tendon
Arrows: Patellar tendon.
Figure 14
Figure 14. Long-axis view of the patellar tendon with MV-Flow tool showing hyperemia within the tendon.
Arrows: Patellar tendon. NOTE: MRI images for this patient were not available for publication.
See this image and copyright information in PMC

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