Work-Related

Musculoskeletal Disorders
in sonography
Onyango Ochieng
Cuhas.
OCCUPATIONAL SAFETY AND
HEALTH ACT (OSHA)
Occupational Safety and Health Act (OSHA) an act passed
by Congress to assure safe and healthful working conditions.Act passed by
Congress in 1970

Covers employers and their employees either directly through federal OSHA
or through an OSHA-approved state program.

 Assures safe and healthful working conditions for workers by setting and
enforcing standards and providing training, outreach, education, and
assistance.
DEFINITION
Work-Related Musculoskeletal Disorders (WRMSD) are injuries that are caused or
aggravated by workplace activities ,including injuries of the muscles, tendons, and joints.
Defined as injuries that:
1. Result in restricted work.
2. Result in days away from work.
3. Involve musculoskeletal disorder symptoms that remain for 7 days or more.
4. Involve musculoskeletal disorder symptoms that require medical treatment beyond
first aid.
Include injuries of the muscles, tendons, and joints.
 Greater than 80 percent of sonographers have some form of WRMSD, most commonly
shoulder pain.
Causes of WRMSD in Sonography
Static work posture.
Awkward scanning posture (i.e., bending, twisting).
 Forceful and repetitive movements.
Prolonged abduction of upper extremity.
 Inappropriate monitor height.
Incorrect or continual grip of the transducer.
Types of Musculoskeletal Injuries
1.Bursitis
IS an Inflammation of a joint bursa, commonly the shoulder Repetitive
motion
cause
Repeated arm abduction restricts blood flow to the soft tissues
2.Carpal tunnel syndrome
Carpal tunnel syndrome Entrapment of the median nerve as it runs
through the carpal bones of the wrist
causes
Repeated flexion and extension of the wrist
Mechanical pressure against the wrist
3.Cubital tunnel syndrome

Entrapment of the ulnar nerve as it runs through the elbow

causes
Repeated twisting of the forearm
Mechanical pressure against the elbow as it rests on the examination
table
4.de Quervain’s disease
is a Specific type of tendonitis of the thumb
cause
Repeated gripping of the transducer
5.Epicondylitis
refers to Inflammation of the periosteum area of the insertion of
the biceps tendon into the distal humerus
cause

Repeated twisting of the forearm

6.Rotator cuff injury
rotator cuff include
(supra spinatus,infraspinatus,teres
minor and subscapularis)

Fraying or tearing of the rotator

cuff of the shoulder Repeated
arm abduction
cause
Repetitive motion
7.Spinal degeneration
 Intervertebral disk degeneration Awkward postures
cause
Static posture
8.Tendonitis
 Inflammation of the tendon and the sheath around the tendon
causes
Repetitive motion
Repeated arm abduction
9.Thoracic outlet syndrome
Thoracic outlet syndrome is a group
of disorders that occur when blood
vessels or nerves in the space
between collarbone and first rib
(thoracic outlet) are compressed.
This can cause pain in shoulders
and neck and numbness in fingers.
Nerve entrapment that can occur at
different levels Repetitive motion
cause
Awkward postures
10.Trigger finger

Inflammation and swelling of

the tendon sheath in a finger
entraps the tendon and restricts
the motion of the finger
cause
Repeated gripping of the
transducer
best practices for reducing the risk for
WRMSDs in sonography.
 Position examination table at a proper height with the patient close enough to avoid bending and
reaching.
 Place monitor directly in front of operator, positioning the monitor height so eyes are even with the top of
the monitor.
 Position the patient close to the sonographer.
 Try to perform some exams from the head or foot of the exam table; try some exams with the patient
seated.
 Use a palmar transducer grip whenever possible.
 Try different transducer grips throughout exams in order to maintain a neutral wrist position.
 Utilize the ergonomic features of the exam room equipment in order to reduce arm abduction, reaching,
and neck and trunk twisting.
 Have cooperative patients self-augment venous flow during lower extremity exams.
cont.....
Optimize the computer workstation equipment for more comfortable
positions.
Avoid unnecessary bedside exams.
Avoid performing the same type of exam repeatedly throughout the
workday.
Consider the ergonomic features when purchasing new equipment.
Above all, avoid static postures. It is important to incorporate
movement into work activities.
point to note
A common static work posture among sonographers is abduction of either the
scanning arm or the nonscanning arm.
 An angle of abduction greater than 30° puts the shoulder at risk for injury,
especially if the arm is abducted for long periods of time.
 Sonographers often scan with excessive arm abduction because they do not
take the time to optimize their position in respect of the patient and the
ultrasound system.
Over-reaching is another common injury-producing work posture.
Reaching with either arm beyond 30 cm for a prolonged period of time can
result in muscle fatigue and possible injury.
 Reach and abduction are both exam specific and depend on a patient’s body
habitus and on the adjustability of exam room equipment.
related pictures(to avoid)
of center monitor
ups obstruction
correct scanning position
ERGONOMICS (where we are)
Study of the human body at work.
Primary goal is to increase productivity while decreasing worker injury.
Accomplished by modifying products, tasks, and worker environment.
MOTTO (TAKE NOTE)
Prevention of injury is the key, and the key to
prevention is education.