Knee ultrasound (musculoskeletal imaging in primary care)

Knee ultrasound

• at the knee many causes of anterior knee pain may be diagnosed with ultrasound
  • anterior knee pain ultrasound diagnosis
    • patella or quadriceps tendinitis or tears
    • pre- or deep infrapatellar bursitis
    • Hoffitis (infrapatellar fat pad)
    • synovial plica with effusion
    • iliotibial band syndrome (runner's knee)
    • synovitis
      
      
• joint line pain from meniscal cysts or popliteal fossa pain caused by Baker's (popliteal) cyst or popliteal artery aneurysm may be diagnosed
  
  
• ultrasound cannot assess the posterior or anterior cruciate ligaments and is not comprehensive enough to assess the collateral ligaments, menisci or osteochondral surfaces

Notes:

Ultrasound applications

• Articular pain, swelling or mechanical symptoms without definitive diagnosis
• Shoulder pain or mechanical symptoms
• Symptoms near a joint
• Regional neuropathic pain to diagnose neural entrapment
• Guiding articular/periarticular aspiration or injection
• Diagnosis and treatment assessment of synovitis

Ultrasound advantages

• Cheaper, more accessible and better tolerated than MRI
• Preferred modality for tendinopathy and muscle trauma
• As accurate as MRI in diagnosis of rotator cuff tears
• Dynamic examination and intervention possible

Reference:

• 1) Arthritis Research UK (Summer 2013). Hands on - Musculoskeletal imaging for GPs.