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Bethesda, MD(301) 530-1010
Dr. Marc GrunerSports & Regenerative Medicine
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Diagnostics

Musculoskeletal ultrasound

Real-time, radiation-free imaging at the point of care: the foundation of accurate diagnosis and precise, image-guided treatment.

The short answer

Diagnostic musculoskeletal (MSK) ultrasound uses high-frequency sound waves to image tendons, ligaments, muscles, nerves, and joints in real time, without radiation. As an RMSK-certified physician, Dr. Gruner uses it to pinpoint the source of pain — often avoiding MRI — and to guide injections and procedures with millimeter precision.

Medically reviewed by Marc Gruner, DO, MBA, RMSK
Sports medicine physician, Mayo Clinic fellowship. Last reviewed June 2026

Diagnostic musculoskeletal ultrasound image of a hip
Diagnostic musculoskeletal ultrasound of the hip. Depth scale in centimeters.

Why musculoskeletal ultrasound matters

Getting the diagnosis right is the most important step in treating musculoskeletal pain. MSK ultrasound gives Dr. Gruner a dynamic window into the injured tissue — the ability to see it move, compare it side to side, and confirm the exact problem while you’re in the room. That precision shapes every treatment decision that follows.

It’s also what makes his regenerative injections and minimally invasive procedures so accurate: the same imaging that diagnoses the problem guides the needle or instrument to the precise target.

What ultrasound adds to your care

Real-time and dynamic

Unlike a static MRI, ultrasound lets Dr. Gruner move the joint and watch tendons, ligaments, and nerves work in real time — often revealing problems a still image misses.

No radiation, point-of-care

The exam is painless and radiation-free, performed in the office. Diagnosis and a treatment plan frequently happen in a single visit.

Equivalent to MRI for many injuries — at lower cost

For tendon and soft-tissue problems, ultrasound is comparable to MRI for detecting tears, at a fraction of the cost and wait.

Millimeter-precise guidance

The same imaging guides injections and procedures to the exact target while protecting nearby nerves and vessels — far more accurate than injecting by feel.

Diagnostic ultrasound detailsUltrasound-guided procedures

Frequently asked questions

Is musculoskeletal ultrasound as good as an MRI?
They're complementary. For tendons, ligaments, nerves, and guiding injections, ultrasound is excellent — often equivalent to MRI for detecting tears — with real-time motion, immediate results, no radiation, and lower cost. MRI remains better for deep structures and bone detail.
What is an RMSK certification?
RMSK (Registered in Musculoskeletal Sonography) is the highest standard of certification for musculoskeletal ultrasound in medicine. Dr. Gruner holds the RMSK credential.
Does a diagnostic ultrasound hurt?
No. A diagnostic ultrasound is painless — a small probe with gel is moved over the skin. Only if the exam is combined with a guided injection is a needle involved.

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