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Symptoms of MSI can occur after months or years of overuse and have been staged according to their reversibility and outcome;
Stage 1 – aching and tiredness that subside with overnight rest; no reduction in work performance.
Stage 2 – recurrent aching and tiredness that do not subside with overnight rest; symptoms occur earlier in the workday & affect performance at work.
stage 3 – aching, fatigue, and weakness result in reduced performance in work and leisure activities; pain occurs with non-repetitive movements; sytmptoms disturb sleep and may last years.

Spcific disorders of MSI are:
• tenosynovitis/tendonitis
• carpal/cubital tunnel syndrome
• trigger finger
• deQuervain’s disease
• lateral/medial epicondylitis
• rotator cuff injury
• bursitis of the shoulder
• thoracic outlet syndrome
• neck/back sprains

Muscles and tendons are designed to stretch and to be used regularly.  However, when frequency and duration of loading exceeds the ability of the muscles and tendons to adapt, inflammation occurs, followed by degeneration, microtears, calcium deposits, and scar formation.  This type of stress is a function of the number of cases a sonographer does daily, particularly the same type of exam.  Work pace, recovery time, and level of muscular effort  lead to these injuries.  Studies have shown that a sonographer may exert up to 40 pounds of pressure during an exam.  Nerve damage can result from arm abduction, flexion and extension of the wrist and/or fingers.
Symptoms of MSI are:
• pain
• muscle spasm
• inflammation
• swelling
• loss of sensation
• numbness
• tingling
• burning
• clumsiness

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