<p begin="00:00:07.746" end="00:00:09.338" style="s2">- [Voiceover] A linear array transducer</p>
<p begin="00:00:09.338" end="00:00:11.582" style="s2">with a musculoskeletal exam type</p>
<p begin="00:00:11.582" end="00:00:13.980" style="s2">is used to perform an<br />ultrasound examination</p>
<p begin="00:00:13.980" end="00:00:17.703" style="s2">of the metatarsal phalangeal<br />joint in the foot.</p>
<p begin="00:00:17.703" end="00:00:20.014" style="s2">The patient is placed<br />in a supine position,</p>
<p begin="00:00:20.014" end="00:00:23.285" style="s2">with the knee flexed<br />and the foot on the bed.</p>
<p begin="00:00:23.285" end="00:00:25.927" style="s2">The transducer is placed<br />over the dorsal surface</p>
<p begin="00:00:25.927" end="00:00:28.017" style="s2">of the metatarsal phalangeal joint</p>
<p begin="00:00:28.017" end="00:00:29.924" style="s2">in a longitudinal fashion,</p>
<p begin="00:00:29.924" end="00:00:31.557" style="s2">with the orientation marker directed</p>
<p begin="00:00:31.557" end="00:00:33.545" style="s2">toward the patient's head.</p>
<p begin="00:00:33.545" end="00:00:35.281" style="s2">The metatarsal head is seen</p>
<p begin="00:00:35.281" end="00:00:38.347" style="s2">as a bright, hyperechoic<br />rounded structure.</p>
<p begin="00:00:38.347" end="00:00:40.487" style="s2">The proximal phalanx can be seen</p>
<p begin="00:00:40.487" end="00:00:42.940" style="s2">as a hyperechoic linear structure,</p>
<p begin="00:00:42.940" end="00:00:45.201" style="s2">just distal to the metatarsal.</p>
<p begin="00:00:45.201" end="00:00:48.264" style="s2">The extensor tendon lies<br />above the bony structures,</p>
<p begin="00:00:48.264" end="00:00:52.106" style="s2">and appears as a hyperechoic<br />fibrillar structure.</p>
<p begin="00:00:52.106" end="00:00:54.796" style="s2">The metatarsal phalangeal<br />joint can be seen</p>
<p begin="00:00:54.796" end="00:00:58.425" style="s2">as a dark hypoechoic region<br />between the metatarsal head</p>
<p begin="00:00:58.425" end="00:01:00.351" style="s2">and the first phalanx.</p>
<p begin="00:01:00.351" end="00:01:02.273" style="s2">The transducer should be slowly moved</p>
<p begin="00:01:02.273" end="00:01:05.612" style="s2">along the medial surface of<br />the metatarsal phalangeal joint</p>
<p begin="00:01:05.612" end="00:01:08.060" style="s2">to evaluate the joint space.</p>
<p begin="00:01:08.060" end="00:01:12.012" style="s2">The transducer is rotated<br />90 degrees counterclockwise</p>
<p begin="00:01:12.012" end="00:01:14.154" style="s2">to obtain a transverse view.</p>
<p begin="00:01:14.154" end="00:01:17.288" style="s2">The extensor tendon appears<br />as an elliptical structure</p>
<p begin="00:01:17.288" end="00:01:19.455" style="s2">above the metatarsal head.</p>
<p begin="00:01:19.455" end="00:01:21.400" style="s2">The transducer should be slowly moved</p>
<p begin="00:01:21.400" end="00:01:25.567" style="s2">to allow a full view of the<br />metatarsal phalangeal joint.</p>