Knee

Question 0

Knee ultrasound indications

Answer 0

Acute trauma
Overuse injuries
Chronic pain, selling or locking of the knee joint

Question 1

Biceps femoris

Answer 1

O- LH ischial tuberosity
SH- linea aspera
I- lateral head of fibula and lateral condyle of tibia
A- extends thigh at hip joint and flexes knee
N- sciatic N

Question 2

Knee joint pathology

Answer 2

• joint fluid in the supra patellar bursa
• commonly seen in trauma, inflammatory, infiltrative and degenerative disorders
• synovial proliferation or pannus shows as a loculated, hypoechoic sometimes

Question 3

Joint effusion pathology

Answer 3

• joint fluid in suprapatellar bursa
• commonly seen in trauma, inflammatory, infiltrative and degenerative disorders
• synovial proliferation or pannus shows as a lobulated, hypoechoic sometimes hypervascular mass within bursa

Question 4

Quadriceps Tendon pathology

Answer 4

• Tendinopathy
• partial tears
• ruptures

Question 5

Patellar Retinaculum

Answer 5

• patellar tears- diffuse thickening

- full thickness tears- focal anechoic defect

Question 6

Prepatellar and superficial infra-patella bursa pathology

Answer 6

Bursitis- fluid and or thickening in prepatellar soft tissues
-use lots of gel and very light transducer pressure

Question 7

Deep infra-patellar bursal pathology

Answer 7

Bursitis deep to the patella tendon-a small amount of fluid is normal, compare to the contralateral side

Question 8

Patellar Tendon Pathology

Answer 8

Tendinopathy- “Jumpers Knee” - focal thickening of the tendon, increased vascularity usually at the patellar attachment

• calcification within the tendon can be seen in chronic tendinopathy
• partial tears
• complete rupture- patella is displaced superiorly

Question 9

Medial knee Pathology

Answer 9

MCL, medial meniscus, Pes anserine bursa and tendons

Question 10

Anterior knee pathology

Answer 10

Joint effusion, quadriceps tendon, patellar retinaculum, patellar and superficial infra- patellar bursa, deep infra-patellar bursa, patellar tendon

Question 11

MCL pathology

Answer 11

• most commonly injured ligament in the knee
• strain-thickening of ligament
• partial tear - usually in deep layer
• O’Donoghues Triad- ACL, MCL and the medial meniscus tear sequentially

Question 12

Pes Anserins pathology

Answer 12

• Bursitis- fluid between the Pes anserine tendon insertion and the tibia
• Pes anserine syndrome - acute or chronic inflammation leading to tendinitis, enthesitis, bursitis or a combination of all three

Question 13

Lateral knee Pathology

Answer 13

Popliteus tendon, LCL, iliotibial band friction syndrome, lateral meniscus

Question 14

Popliteus tendon pathology

Answer 14

Tendinopathy with or without an associated bursitis

Question 15

LCL pathology

Answer 15

• partial tears
• complete tears
• tears usually sited at distal attachment
• do not confuse the overlying biceps femoris as focal thickening of the ligament

Question 16

Iliotibial band friction syndrome

Answer 16

• runners knee
• thickening of the band with or without an underlying bursitis
• avulsion fracture at Gerdy’s tubercle

Question 17

Lateral meniscus pathology

Answer 17

Tears- usually occur medially

Cysts- meniscal or parameniscal - can be uni or multlocular

Question 18

Posterior knee pathology

Answer 18

Gastrocnemius- semimembranosus bursa, PCL

Question 19

Gastrocnemius-semimembranosus bursa

Answer 19

Bakers cyst- simple or complex, may dissect, rupture or sequester

Question 20

PCL pathology

Answer 20

• tears usually in conjunction with MCL, meniscal or bony injuries
• cysts often seen overlying PCL

Question 21

Popliteal

Answer 21

O- lateral condyle of femur
I- proximal posterior tibia
A- flexes leg, rotates leg medially
N - tibial N

Question 22

Rectus femoris

Answer 22

O- ASIS and ilium above acetabulum
I- patella, then tibia via patella tendon
A- extends leg and flexes thigh
N- femoral N