The purpose of this home study course is to introduce clinicians to diagnostic musculoskeletal ultrasound imaging as a highly effective, non-invasive diagnostic tool that complements manual therapy, dry needling, and regenerative interventions.

Through a combination of lecture, video demonstration, and clinical case studies, participants will build confidence in tissue identification, understand pathology progression, and learn how ultrasound-guided percutaneous tenotomy stimulates tissue healing in chronic tendinopathies.

• Musculoskeletal ultrasound physics and principles
• • Understanding image echogenicity (anechoic, hyperechoic, hypoechoic)
    
  • Knobology and image optimization techniques
    
  • The “5 Ps” for repeatable and consistent imaging
    
  • Identification of normal vs pathological tissues:
    
    • Tendons
      
    • Ligaments
      
    • Muscles
      
    • Nerves
      
    • Cartilage
      
    • Vasculature
      
  • Real-time dynamic imaging examples (shoulder, knee, elbow, Achilles)
    
  • Histology of tendinopathy and enthesis dysfunction
    
  • Percutaneous needle tenotomy (PNT) theory and application

Module 1: Welcome to Diagnostic Ultrasound Foundations
An introduction to the Diagnostic Ultrasound Foundations course, highlighting its hands-on format and practical applications in clinical settings. The instructor shares their journey with ultrasound-guided dry needling and outlines what students can expect from the course.

Module 2: The Case for Ultrasound in Physical Therapy
This module builds the case for incorporating ultrasound into PT practice. It explores APTA recommendations, the advantages of real-time imaging, and how ultrasound can enhance diagnostic accuracy and patient outcomes.

Module 3: Ultrasound Physics, Probes & Knobology
Dive into the physics behind ultrasound, including probe types and the concept of “knobology.” Learn how piezoelectric crystals create detailed musculoskeletal images and how to select and manipulate probes for optimal results.

Module 4: Real-Time Imaging & Motion-Based Diagnostics
Explore real-time ultrasound imaging and dynamic diagnostics. Understand how pulse-echo mechanisms translate into live images and learn techniques for manipulating pulse frequency, amplitude, and depth to assess movement-based pathology.

Module 5: Reading the Image: Grayscale & Echogenicity
This session covers how to interpret ultrasound images using grayscale and echogenicity. Understand concepts like attenuation, hyperechoic vs. anechoic signals, and how tissue composition affects image clarity and diagnostic value.

Module 6: The 5 Ps of Consistent Imaging
Consistency is key in imaging. This module introduces the “5 Ps”: Patient Position, Provider Position, Probe Position, Parameters, and Picture. Learn the strategies that ensure image reproducibility and reliability across users and time.

Module 7: Tendons & Tendinopathy Explained
A deep dive into tendon structure and pathology. Understand the enthesis, blood supply, and how normal vs. abnormal tendon images appear. Learn to distinguish tendinosis and understand the importance of identifying “normal” first.

Module 8: Ultrasound-Guided Percutaneous Tenotomy
Learn about the clinical and physiological basis of percutaneous needle tenotomy (PNT) and dry needling for tendinopathy. Research-backed insights demonstrate how fenestration disrupts degenerative tissue to stimulate healing.

Module 9: Case Studies and Clinical Outcomes
Review compelling case studies showing the real-world effects of ultrasound-guided interventions. Track structural changes and symptom improvement over time, validating the clinical effectiveness of PNT and dry needling techniques.

At the completion of this course, participants will be able to:

• Understand the physics behind diagnostic musculoskeletal ultrasound.
  
• Identify normal and abnormal tissue structures in ultrasound images.
  
• Perform proper patient and probe positioning for optimal image acquisition.
  
• Recognize ultrasound findings related to tendinopathy and enthesis dysfunction.
  
• Explain the principles of ultrasound-guided percutaneous tenotomy.
  

Appreciate the clinical application of regenerative dry needling under ultrasound guidance.

Must be a licensed healthcare provider (PT, DC, DO, MD, NP, PA, OT, ATC)