Overview
Diagnostic musculoskeletal (MSK) ultrasound uses high-frequency sound waves to produce real-time images of tendons, muscles, ligaments, joints, bursae, and nerves. Unlike MRI or X-ray, it is dynamic — Dr. Portwood can move the joint while imaging it, watching the structure in motion to see exactly what is catching, tearing, or impinging.
Dr. Charles Portwood is board certified in musculoskeletal ultrasound (RMSK), a credential held by relatively few providers in the region. That means scans at Philiatros Healthcare are performed and interpreted by the same provider treating you — no shipping images out, no waiting days for a radiology report. You see the findings on the screen during your visit.
Conditions treated
- Rotator cuff tears and tendinopathy
- Biceps tendon pathology
- Shoulder impingement and bursitis
- Tennis elbow (lateral epicondylitis)
- Golfer's elbow (medial epicondylitis)
- Carpal tunnel syndrome (median nerve)
- Trigger finger and de Quervain tenosynovitis
- Hip bursitis and gluteal tendinopathy
- Knee meniscal and ligament evaluation
- Patellar and quadriceps tendinopathy
- Achilles tendon tears and tendinopathy
- Plantar fasciitis
- Morton’s neuroma
- Joint effusions and synovitis
- Soft-tissue masses and ganglion cysts
What to expect
Focused history & exam
Imaging is only as useful as the clinical question behind it. We start by identifying exactly which structure is suspected so the scan answers a specific question.
Real-time scan
You lie or sit comfortably while warm gel and a probe are placed on the area of concern. Most scans take 10–20 minutes and involve no radiation, no contrast, and no needles.
Dynamic assessment
Unique to ultrasound: Dr. Portwood can move your joint or have you contract a muscle while imaging it, revealing tendon snapping, nerve entrapment, or instability that is invisible on a static MRI.
Same-visit findings
Results are explained on the screen during your visit, with annotated still images saved to your record. No waiting days for an outside radiology report.
Treatment plan or referral
Findings drive the plan. If conservative care is appropriate, we begin treatment. If surgery, MRI, or another specialist is the better path, we coordinate the referral.
Why MSK ultrasound — and why RMSK matters
For many soft-tissue problems, ultrasound is a better first-line study than MRI. It is faster, less expensive, radiation-free, and uniquely able to image structures in motion. The catch: ultrasound is operator-dependent. The image is only as good as the person holding the probe.
That is why credentialing matters. The Registered in Musculoskeletal Sonography (RMSK) certification, granted by the Alliance for Physician Certification & Advancement, is awarded only after documented case experience and a rigorous exam. Dr. Portwood holds this credential and uses ultrasound daily — so the scan you receive here is performed by someone who knows what normal, abnormal, and in-between look like across thousands of prior cases.
- No radiation — safe to repeat as often as needed
- Dynamic — image structures in motion, not just at rest
- Same-visit results — interpreted on the spot, not days later
- Lower cost than MRI for most tendon, ligament, and nerve evaluations
Frequently Asked Questions
How is ultrasound different from MRI for musculoskeletal problems?
Both image soft tissue. MRI is better for deep structures, bone marrow, and the spine. Ultrasound is better for superficial tendons, ligaments, nerves, and small joints — and it is the only modality that can image those structures in motion. For many shoulder, elbow, wrist, and ankle problems, ultrasound answers the question faster and at lower cost than MRI.
Is musculoskeletal ultrasound safe?
Yes. Diagnostic ultrasound uses sound waves, not radiation. There are no known harmful effects at diagnostic intensities, and scans can be repeated as often as clinically needed — including during pregnancy when appropriate.
What does RMSK certification mean?
RMSK stands for Registered in Musculoskeletal Sonography. It is a board certification awarded by the Alliance for Physician Certification & Advancement after the candidate documents extensive case experience and passes a rigorous exam. Relatively few providers in the region hold it.
Do I need a referral for an ultrasound?
No referral is required to be evaluated at our office. If your primary care provider, orthopedist, or another specialist has requested imaging, bring their order and any prior studies — we will coordinate findings back to them.
Will my insurance cover the ultrasound?
Diagnostic musculoskeletal ultrasound is a covered service under most insurance plans when medically necessary. We will help verify your benefits and explain any out-of-pocket cost before the scan is performed.
Do you perform ultrasound-guided injections?
We use diagnostic ultrasound to identify the source of pain and to direct treatment planning. If an ultrasound-guided injection is the appropriate next step, we coordinate referral to a regional specialist who performs them.