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Yr 2 - Movement > Ultrasound of the Lower Limb > Flashcards

Ultrasound of the Lower Limb Flashcards

1
Q

What frequency should be used for the patella tendon? Why?

A

10-15 MHz - relatively superficial

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2
Q

What frequency should be used for the suprapatellar pouch? Why?

A

7.5-12 MHz - slightly deeper structure so slightly lower frequency is required

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3
Q

What is the routine for a knee US?

A
  • Patellar tendon
  • Quadriceps tendon
  • Supra-patella pouch
  • Medial and lateral joint space
  • Posterior knee
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4
Q

How is the probe held in an US of the proximal patella tendon? What position is the knee in?

A
  • Knee in slightly flexed position
  • Probe held in longitudinal position
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5
Q

US image of a patella tendon

A
  • Hoffa’s fat pad
    • An area under the patella tendon
  • Dermis and subcutaneous tissue above the patella tendon
  • Above the patella is the prepatellar bursa (can’t see in this image)
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6
Q

What is an acoustic shadow?

A

Is characterised by a signal void behind structures that strongly absorb or reflect ultrasonic waves. It is a form of imaging artifact. This happens most frequently with solid structures, as sound conducts most rapidly in areas where molecules are closely packed, such as in bone or stones.

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7
Q

What is an ‘imaging artifact’?

A

An image artifact is any feature which appears in an image which is not present in the original imaged object.

i.e. seen here where the pointer is

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8
Q

What is an anisotropy?

A

An artefact encountered in ultrasound, notably in muscles and tendons during a musculoskeletal ultrasound. In musculoskeletal applications, the artefact may prompt an incorrect diagnosis of tendinosis or tendon tear.

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9
Q

What artifact are tendons susceptible to?

A

Anisotropy

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10
Q

Transverse US of proximal patella tendon

A
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11
Q

Longitudinal vs transverse view of the fibre bundles

A
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12
Q

Transverse view of fibres

A
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13
Q

What does this image show? (clue; patella tendinopathy)

A
  • A thickened tendon
  • Hypoechogenic tendon
    • More dense or solid than usual
  • Increased vascularity

Proximal patellar tendinopathy

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14
Q

Where does the quads tendon insert?

A

Proximal pole of the patella

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15
Q

How should the probe be held durng quadds tendon US?

A

Longitudinal

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16
Q

Longitudinal quads tendon US image

A

N.B. should say femoral condyle instead of femoral head

17
Q

US of quadriceps tendon ‘enthesitis’

A

Enthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone.

  • Tendon thicker and darker than normal (hypoechogenic)
  • Common aspect of psoriatic arthritis
18
Q

Position of knee during US of inter-trochlear groove and hyaline cartilage? Position of probe?

A
  • Knee very flexed
  • Probe transverse
19
Q

US image of inter-trochlear groove and hyaline cartilage

A
20
Q

A longitudinal view through the suprapatellar pouch - sonographic landmarks

A

The line represents the normal suprapatellar pouch. The full length of the pouch should be examined from the patella to most proximal aspect of the pouch.

21
Q

Where does the suprapatellar pouch lie between?

A

Lies between the supra-patellar fat pad and the pre-femoral fat pad

22
Q

Appearance of distended SPP - This is a longitudinal view through the suprapatellar pouch (SPP).

A
  • The distended pouch can be seen as the fat plains of the supra-patella fat (SPF) and pre-femoral fat (PFF) are separated.
  • The fluid (effusion) and synovial hypertrophy can be seen
  • Thickened synovium with increased vascularity
23
Q

Removal of fluid for analysis; different types of fluid

US can be used to help guide fluid removal

A
24
Q

Normal synovial fluid

A
  • Straw coloured
  • Quite clear
25
Q

Longitudinal muscle view

A
26
Q

Transverse muscle view

A
27
Q

What is a Doppler US?

A

A Doppler ultrasound is a noninvasive test that can be used to estimate the blood flow through your blood vessels by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells.

28
Q

US of relaxed muscle

A
29
Q

US of contracted muscle

A
30
Q

Medial knee - longitudinal US

A
31
Q

Meniscal bulge and tear US

A
32
Q

To US the posterior knee, what might you have to do to the probe frequency?

A

Deeper structures - frequency would need to be lowered

33
Q

Posterior knee US

A
34
Q

How do you different between popliteal vein and artery?

A
  • Popliteal artery is normally deeper than the vein
  • Vein is compressable with overlying transducer pressure but artery wouldn’t
35
Q

What is Baker’s cyst?

A
  • A Baker’s cyst is a fluid-filled cyst that causes a bulge and a feeling of tightness behind your knee
  • Usually the result of a problem with your knee joint, such as arthritis or a cartilage tear
  • Come from the bursa betwen the medial head of gastrocnemius and the semi-membranosus tendon
36
Q

US of Baker’s cyst

A
37
Q

What complications might follow a Baker’s cyst?

A
  • Rupture
  • DVT
  • Arterial compression and ischaemia
  • Peripheral neuropathy
  • Infection
38
Q

Signs of a ruptured Baker’s cyst?

A
  • Typically mimics a DVT
  • Crescent sign

Yr 2 - Movement (39 decks)

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