Medical sonography involves awkward postures, extreme joint positions, forceful repetitive movements, and periods of applied static muscle force, and prior research has shown that sonographers are at an increased risk for developing musculoskeletal disorders, particularly in the low back, neck, and upper extremities. The specific aim of this study is to identify risk factors for the development of MSDs medical sonographers using questionnaires and ergonomic job analysis and to quantify the risk factors through strength tests and biomechanical analysis methods.

A pilot study was performed at the University of Louisville Hospital Ultrasound Facility and the research was performed in accordance with the approved protocol (#233.07) from the University of Louisville's Institutional Review Board (IRB). Seven full-time sonographers gave their consent to participate in the study. Customized questionnaires were used to determine the prevalence of musculoskeletal disorders and the existence of perceived risk factors for injury. Ergonomic job evaluation was completed using Rapid Upper Limb Assessment (RULA). The push force necessary to perform a variety of ultrasound scans was recorded and grip strength before and after performing ultrasound scans was measured. Electrogoniometers were used to measure upper extremity joint angles and surface electromyography was used to analyze muscle activity.

6 out of 7 (86%) sonographers reported musculoskeletal pain in at least one upper extremity joint, and all sonographers perceived sustained transducer usage, sustained shoulder abduction, and scanning large or obese patients to be risk factors for injury. Performing ultrasound scans significantly reduced the amount of grip strength which could be exerted. Initial grip strength at the beginning of the day was significantly greater than final grip strength at the end of the day for both the right and left arms. Larger shoulder abduction angles, deltoid muscle activity, and deltoid muscle fatigue were observed for left sided than right sided scans.

Based on the results of these analyses, we believe that the sonographers at the Diagnostic Imaging Facility at the University of Louisville Hospital are at an increased risk of developing work-related musculoskeletal pain or injury. Future research could include the proposal of possible intervention techniques to help reduce or eliminate the work-related risk factors.