Abstract
The hardware improvements in the last 20 years have impressively increased the capabilities of ultrasound in the assessment of the musculoskeletal system. Ultrasound is now considered in many clinical situations as the first-line imaging technique to evaluate limb disorders because of its high definition and dynamic capabilities. In addition, ultrasound is a low-cost, patient-friendly, and readily available technique. Ultrasound is less performant than magnetic resonance imaging in the evaluation of most intra-articular knee structures. However, it allows assessment of several disorders affecting tendons, vessels, and nerves, as well as other periarticular structures. This chapter describes the standard technique of ultrasound examination of knee, the normal ultrasound anatomy, as well as selected ultrasound pathologic images.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Adriani E, Mariani PP, Maresca G et al (1995) Healing of the patellar tendon after harvesting of its mid-third for anterior cruciate ligament reconstruction and evolution of the unclosed donor site defect. Knee Surg Sports Traumatol Arthrosc 3:138–143
Aghaghazvini L, Tahmasebi MN, Gerami R et al (2020) Sonography: a sensitive and specific method for detecting trochlear cartilage pathologies. J Ultrasound 23:259–263
Andrés M, Sivera F, Pascual E (2020) Progresses in the imaging of calcium pyrophosphate crystal disease. Curr Opin Rheumatol 32:140–145
Berkoff DJ, Miller LE, Block JE (2012) Clinical utility of ultrasound guidance for intra-articular knee injections: a review. Clin Interv Aging 7:89–95
Bianchi S (2020) Ultrasound and bone: a pictorial review. J Ultrasound 23:227–257
Bianchi S, Martinoli C (1999) Detection of loose bodies in joints. Radiol Clin N Am 37:679–690
Bianchi S, Martinoli C (2007) Ultrasound of the musculoskeletal system. Springer, New York
Bianchi S, Zwass A, Abdelwahab IF et al (1994) Diagnosis of tears of the quadriceps tendon of the knee: value of sonography. AJR Am J Roentgenol 162:1137–1140
Bianchi S, Zwass A, Abdelwahab IF et al (1995a) Sonographic evaluation of intramuscular ganglia. Clin Radiol 50:235–236
Bianchi S, Zwass A, Abdelwahab IF et al (1995b) Sonographic evaluation of lipohemarthrosis: clinical and in vitro study. J Ultrasound Med 14:279–282
Bianchi S, Martinoli C, Demondion X (2006) Écho-anatomie et pathologies des nerfs autour du genou. In: Vande Berg B, Bianchi S, Nizard R et al (eds) Le Genou. Une approche pluridisciplinaire. Sauramps Médical, Montpellier
Bianchi S, Draghi F, Beggs I (2011) Ultrasound of the peripheral nerves. In: Allan P, Baxter G, Weston M (eds) Clinical ultrasound. Churchill Livingstone Elsevier, Edinburgh
Bianchi S, Droz L, Deplaine CL et al (2018) Ultrasound of the sural nerve: normal and pathological appearance. A pictorial essay. J Ultrasound Med 37:1257–1265
Bianchi S, Fischer B, Prues-Latour V et al (2020) Ultrasound of complications after arthroscopic anterior cruciate ligament reconstruction: A pictorial essay. J Ultrasound Med 39:169–179
Blankstein A, Cohen I, Salai M et al (2001) Ultrasonography: an imaging modality enabling the diagnosis of bipartite patella. Knee Surg Sports Traumatol Arthrosc 9:221–224
Bode G, Hammer T, Karvouniaris N et al (2017) Patellar tendinopathy in young elite soccer—clinical and sonographical analysis of a German elite soccer academy. BMC Musculoskelet Disord 18:344
Bonaldi VM, Chhem RK, Drolet R et al (1998) Iliotibial band friction syndrome: sonographic findings. J Ultrasound Med 17:257–260
Cesmebasi A, Spinner RJ, Smith J et al (2016) Role of sonography in the diagnosis and treatment of common peroneal neuropathy secondary to fabellae. J Ultrasound Med 35:441–447
Chen H (2015) Diagnosis and treatment of a lateral meniscal cyst with musculoskeletal ultrasound. Case Rep Orthop 2015:432187
Cook JL, Khan KM, Harcourt PR et al (1998) Patellar tendon ultrasonography in asymptomatic active athletes reveals hypoechoic regions: a study of 320 tendons. Victorian Institute of Sport Tendon. Clin J Sport Med 8:73–77
Creteur V, De Angelis R, Absil J et al (2021) Sonographic and radiographic evaluation of the extensor tendons in early postoperative period after total knee arthroplasty. Skelet Radiol 50:485–494
Curtis BR, Huang BK, Pathria MN et al (2019) Pes anserinus: anatomy and pathology of native and harvested tendons. AJR Am J Roentgenol 213:1107–1116
De Maeseneer M, Marcelis S, Boulet C et al (2014) Ultrasound of the knee with emphasis on the detailed anatomy of anterior, medial, and lateral structures. Skelet Radiol 43:1025–1039
Dirrichs T, Quack V, Gatz M et al (2018) Shear wave elastography (SWE) for monitoring of treatment of tendinopathies: a double-blinded, longitudinal clinical study. Acad Radiol 25:265–272
Draghi F, Corti R, Urciuoli L et al (2015) Knee bursitis: a sonographic evaluation. J Ultrasound 18:251–257
Draghi F, Ferrozzi G, Urciuoli L et al (2016) Hoffa’s fat pad abnormalities, knee pain and magnetic resonance imaging in daily practice. Insights Imaging 7:373–383
Fornage BD (1987) The hypoechoic normal tendon. A pitfall. J Ultrasound Med 6:19–22
Fritschy D, Fasel J, Imbert JC et al (2006) The popliteal cyst. Knee Surg Sports Traumatol Arthrosc 14:623–628
Gebhard F, Authenrieth M, Strecker W et al (1999) Ultrasound evaluation of gravity induced anterior drawer following anterior cruciate ligament lesion. Knee Surg Sports Traumatol Arthrosc 7:166–172
Gerngross H, Sohn C (1992) Ultrasound scanning for the diagnosis of meniscal lesions of the knee joint. Arthroscopy 8:105–110
Giokits-Kakavouli G, Karokis D, Raftakis I et al (2016) Ultrasound of the knee in rheumatology: pitfalls, what is new? J Rheumatol 27:151–160
Grobbelaar N, Bouffard JA (2000) Sonography of the knee, a pictorial review. Semin Ultrasound CT MR 21:231–274
Guillin R, Mendoza-Ruiz JJ, Moser T et al (2010) Snapping biceps femoris tendon: a dynamic real-time sonographic evaluation. J Clin Ultrasound 38:435–437
Gyaran IA, Spiezia F, Hudson Z et al (2010) Sonographic measurement of iliotibial band thickness: an observational study in healthy adult volunteers. Knee Surg Sports Traumatol Arthrosc 19:458–461
Hauzeur JP, Mathy L, De Maertelaer V (1999) Comparison between clinical evaluation and ultrasonography in detecting hydrarthrosis of the knee. J Rheumatol 26:2681–2683
Jacobson JA, Lenchik L, Ruhoy MK et al (1997) MR imaging of the infrapatellar fat pad of Hoffa. Radiographics 3:675–691
Jiménez Díaz F, Gitto S, Sconfienza LM et al (2020) Ultrasound of iliotibial band syndrome. J Ultrasound 23:379–385
Jozwiak M, Pietrzak S (1998) Evaluation of patella position based on radiologic and ultrasonographic examination: comparison of the diagnostic value. J Pediatr Orthop 18:679–682
Kazam JK, Nazarian LN, Miller TT et al (2011) Sonographic evaluation of femoral trochlear cartilage in patients with knee pain. J Ultrasound Med 30:797–802
Khy V, Wyssa B, Bianchi S (2012) Bilateral stress fracture of the tibia diagnosed by ultrasound. A case report. J Ultrasound 15:130–134
Klauser AS, Miyamoto H, Bellmann-Weiler R et al (2014) Sonoelastography: musculoskeletal applications. Radiology 272:622–633
Le Corroller T, Lagier A, Pirro N et al (2011) Anatomical study of the infrapatellar branch of the saphenous nerve using ultrasonography. Muscle Nerve 44:50–54
Learch TJ, Braaton M (2000) Lipoma arborescens: high-resolution ultrasonographic findings. J Ultrasound Med 19:385–389
Lee MJ, Chow K (2007) Ultrasound of the knee. Semin Musculoskelet Radiol 11(2):137–148
Lee JI, Song IS, Jung YB et al (1996) Medial collateral ligament injuries of the knee: ultrasonographic findings. J Ultrasound Med 15:621–625
Lee J-H, Kim K-J, Jeong Y-G et al (2014) Pes anserinus and anserine bursa: anatomical study. Anat Cell Biol 47:127–131
Martino F, De Serio A, Macarini L et al (1998) Ultrasonography versus computed tomography in evaluation of the femoral trochlear groove morphology: a pilot study on healthy, young volunteers. Eur Radiol 8:244–247
Martinoli C, Bianchi S, Spadola L et al (2000) Multimodality imaging assessment of meniscal ossicle. Skelet Radiol 29:481–484
Mathieu P, Wybier M, Busson J et al (1997) The medial collateral ligament of the knee. Ann Radiol 40:176–181
Mikkilineni H, Delzell PB, Andrish J et al (2018) Ultrasound evaluation of infrapatellar fat pad impingement: an exploratory prospective study. Knee 25:279–285
Möller I, Bong D, Naredo E et al (2008) Ultrasound in the study and monitoring of osteoarthritis. Osteoarthr Cartil 16:S4–S7
Moraux A, Bianchi S, Le Corroller T (2018) Soft tissue masses of the knee related to a focal defect of the lateral patellar retinaculum. J Ultrasound Med 37:1821–1825
Moraux A, Bianchi S, Tassery F et al (2019) The lateral patellar retinaculum defect: anatomical study using ultrasound. Skelet Radiol 48:1753–1758
Moraux A, Bianchi S, Le Corroller T (2020) Anterolateral knee pain related to thrombosed lateral patellar retinaculum veins: unusual anterolateral pain of the knee [published online ahead of print, 2020 Apr 1]. J Clin Ultrasound 48:275–278
Nguyen JC, De Smet AA, Graf BK et al (2014) MR imaging-based diagnosis and classification of meniscal tears. Radiographics 34:981–999
Olewnik Ł, Tubbs RS, Ruzik K, Podgórski M, Aragonés P, Waśniewska A, Karauda P, Szewczyk B, Sanudo JR, Polguj M (2021) Quadriceps or multiceps femoris?-Cadaveric study. Clin Anat 34(1):71–81. https://doi.org/10.1002/ca.23646. Epub 2020 Sep 9. PMID: 32644202
Park Y, Lee SC, Nam HS et al (2011) Comparison of sonographically guided intra-articular injections at 3 different sites of the knee. J Ultrasound Med 30:1669–1676
Park GY, Kwon DR, Kwon DG (2020) Clinical, radiographic, and ultrasound findings between simple and complicated baker’s cysts. Am J Phys Med Rehabil 99:7–12
Patil PB, Kamalapur MG, Joshi SK et al (2011) Lipoma arborescens of knee joint: role of imaging. J Radiol Case Rep 5:7–25
Poboży T, Kielar M (2016) A review of ultrasonographic methods for the assessment of the anterior cruciate ligament in patients with knee instability - diagnostics using a posterior approach. J Ultrason 16(66):288–95. https://doi.org/10.15557/JoU.2016.0029. Epub 2016 Sep 7. PMID: 27679732; PMCID: PMC5034023.
Ptasznik R, Feller J, Bartlett J et al (1995) The value of sonography in the diagnosis of traumatic rupture of the anterior cruciate ligament of the knee. AJR Am J Roentgenol 164:1461–1463
Riegler G, Jengojan S, Mayer JA et al (2018) Ultrasound anatomic demonstration of the infrapatellar nerve branches. Arthroscopy 34:2874–2883
Rutten MJ, Collins JM, van Kampen A et al (1998) Meniscal cysts: detection with high-resolution sonography. AJR Am J Roentgenol 171:491–496
Sankepally P, Khatoon HM, Srirambhatla A, Arora AJ (2022). Extraarticular Synovial Osteochondromatosis in Baker’s Cysts Bilaterally: a Rare Presentation. Maedica (Bucur) 17(4):999–1001. https://doi.org/10.26574/maedica.2022.17.4.999. PMID: 36818241; PMCID: PMC9923057.
Scarciolla L, Herteleer M, Turquet E et al (2021) Anatomical study of the proximal tibiofibular ligaments using ultrasound. Insights Imaging 18(12):27
Seymour R, Lloyd DC (1998) Sonographic appearances of meniscal cysts. J Clin Ultrasound 26(1):15–20
Shapiro SA, Hernandez LO, Montero DP (2017) Snapping pes anserinus and the diagnostic utility of dynamic ultrasound. J Clin Imaging Sci 17(7):39
Starok M, Lenchik L, Trudell D et al (1997) Normal patellar retinaculum: MR and sonographic imaging with cadaveric correlation. AJR Am J Roentgenol 168:1493–1499
Taljanovic MS, Gimber LH, Becker GW et al (2017) Shear-wave elastography: basic physics and musculoskeletal applications. Radiographics 37:855–870
Tamborrini G, Bianchi S (2020) Ultrasound of the knee (adapted according to SGUM guidelines). Praxis (Bern 1994) 109:991–1000
Wu WT, Lee TM, Mezian K, Naňka O, Chang KV, Özçakar L (2022) Ultrasound Imaging of the Anterior Cruciate Ligament: A Pictorial Essay and Narrative Review. Ultrasound Med Biol 48(3):377–396. https://doi.org/10.1016/j.ultrasmedbio.2021.11.004. .Epub 2021 Dec 21. PMID: 34949491.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Bianchi, S., Créteur, V., Moraux, A., Tamborrini, G. (2023). Ultrasound. In: Davies, M., James, S., Botchu, R. (eds) Imaging of the Knee. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2022_351
Download citation
DOI: https://doi.org/10.1007/174_2022_351
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-29730-4
Online ISBN: 978-3-031-29731-1
eBook Packages: MedicineMedicine (R0)