Musculoskeletal UltrasoundUltrasound of joints, muscles, tendons, and nerves — protocols and interpretation.
In tendinopathy, shear wave elastography (SWE) demonstrates reduced stiffness of the affected tendon: tendinopathic tendons show lower SWE values. No unified threshold value exists—data vary between …
Read →Ultrasound of large vessels is included in the diagnostic workup of giant cell arteritis as a method for visualizing the vessel wall of temporal and axillary …
Read →The key to ultrasound differentiation is the localization of deposits. In CPPD (calcium pyrophosphate dihydrate arthropathy), calcium pyrophosphate crystals are deposited within hyaline cartilage as an …
Read →Dynamic sonography is an effective and accurate method for evaluating ulnar nerve instability. The transducer is placed transversely over the medial epicondyle with minimal compression, and …
Read →In spondyloarthritides (e.g., psoriatic arthritis), ultrasound reveals inflammatory enthesitis at tendon attachment sites: abnormal hypoechogenicity, hyperemia, erosions, and enthesophytes. The key differential feature is the character …
Read →Bone erosion on ultrasound is described within the framework of standardized OMERACT (Outcome Measures in Rheumatology) semiotics. The key task for the clinician is to distinguish …
Read →Ultrasound accurately detects and localizes foreign bodies in soft tissues, including radiolucent ones (wood, plastic). Virtually all foreign bodies are hyperechoic and produce a reverberation artifact …
Read →Ultrasound differentiation relies on a complex of signs: aseptic bursitis (trauma, gout, inflammatory arthropathy) presents with bursa distension by fluid containing echogenic inclusions; septic bursitis may …
Read →On ultrasound, Baker's cyst is a fluid collection in the popliteal fossa, often heterogeneous (fluid, debris, echogenic reflectors). Key differentiation: DVT (visualized thrombus in vein, incompressible …
Read →Ultrasound diagnosis of enthesitis in spondyloarthropathies (including psoriatic arthritis) relies on detection of hypoechogenicity, hyperemia, erosions, and enthesophytes in the tendon attachment zone (Jacobson, 2026). The …
Read →Dactylitis is one of the key features of psoriatic arthritis, accessible for detection on ultrasound alongside synovitis, enthesitis, and tenosynovitis. Ultrasound with color Doppler application allows …
Read →In the provided source fragments, the Gartner classification of calcifications in calcifying tendinitis is not described [clarification needed]. Available data cover US semiotics of deposits: from …
Read →Ultrasound in tarsal tunnel syndrome is aimed at visualization of the posterior tibial nerve and detection of compressing substrate (ganglion cyst, mass, post-traumatic changes). The method …
Read →For the median nerve CSA <6 mm² excludes, and >12 mm² indicates carpal tunnel syndrome; for the ulnar nerve in the cubital tunnel, the norm is …
Read →On ultrasound of soft tissues, malignancy is indicated by the absence of recognizable features of benign superficial tumors, disorganized internal vascularization on color Doppler ultrasound (CDU), …
Read →On ultrasound, a typical lipoma appears as a well-demarcated lesion with linear echogenic septa, acoustic enhancement, and minimal blood flow; the diagnosis is usually straightforward. Features …
Read →Dynamic ultrasound is the method of choice for detecting transient peroneal tendon subluxation behind the lateral malleolus during provocative maneuvers. Key technical aspects include anisotropy correction …
Read →The key and most useful ultrasound sign of plantar fasciitis is thickening of the plantar fascia at the calcaneal attachment zone >4 mm (normal <4 mm …
Read →The provided source fragments do not contain data on posterior tibial tendon dysfunction (PTTD), its stages, and specific ultrasound findings. Preparation of a reliable article on …
Read →Basic clinical grading of muscle injuries (grade 1-3) and morphological assessment of contusions, DOMS, and tears are applicable on ultrasound. The BAMIC system (British Athletics Muscle …
Read →On ultrasound, complete avulsion of proximal hamstring tendons is visualized as absence of tendons at the ischial tuberosity with distal retraction of the tendon stump; an …
Read →Ultrasound allows for the diagnosis of most ganglion cysts of the wrist by tracing the stalk to the source joint. Key features: anechoic or hypoechoic multilobular …
Read →In trigger finger, ultrasound reveals a hypoechoic thickening of the A1 pulley at the level of the metacarpophalangeal joint. Normally, the A1 thickness is <0.5 mm, …
Read →Rupture of A2/A4 annular ligaments in climbers is diagnosed via ultrasound by the bowstring sign — volar displacement of the flexor tendons during forced flexion. Normally, …
Read →On ultrasound, cubital tunnel syndrome is diagnosed by a hypoechoic fusiform swelling of the ulnar nerve proximal to the tunnel. A cross-sectional area (CSA) >9 mm² …
Read →Ultrasound allows differentiation between complete and partial tears of the distal biceps tendon. A medial approach through the 'pronator window' is used for assessment (Smith et …
Read →The dynamic valgus stress test is a key step in the ultrasound assessment of the anterior band of the ulnar collateral ligament (UCL) in throwers. The …
Read →According to Graf's method, the maturity of the hip joint is assessed in the standard coronal projection. The alpha angle reflects the bony part of the …
Read →In greater trochanteric syndrome, ultrasound distinguishes two mechanisms: tendinopathy of the gluteus medius/minimus tendons and trochanteric bursitis. Tendinopathy is characterized by thickening, hypoechogenicity, and loss of …
Read →The provided source fragments do not contain data on the measurement of the anterior recess of the hip joint, specific millimeter thresholds for effusion, and the …
Read →Dynamic ultrasound is the method of choice for snapping hip: it visualizes in real-time the internal type (abnormal movement of the iliopsoas tendon relative to anterior …
Read →The TFCC is evaluated during wrist ultrasound with reference points on the distal ulna, triquetrum, lunate, and the extensor carpi ulnaris tendon. However, the provided source …
Read →An intracompartmental septum of the first extensor compartment is an important anatomical variation in de Quervain's disease, dividing the APL and EPB tendons into separate subcompartments. …
Read →The current AIUM parameter for musculoskeletal ultrasound was revised in 2022 and published in 2023 as a joint document by AIUM/ACR/SPR/SSR. The document does not introduce …
Read →EULAR-OMERACT uses a combined joint synovitis score of 0–3: gray-scale synovial hypertrophy 0–3 plus power Doppler 0–3. The 2025 validation demonstrated good construct validity of this …
Read →The ESSR consensus on lower limb nerves includes 9 statements, all with strong expert consensus. The main practical conclusion: Ultrasound or other image-guided access is indicated …
Read →In 2023, OMERACT proposed a validated ultrasound scale for CPPD with a grading of 0–3 to assess the extent of calcium pyrophosphate deposits. At the joint …
Read →EULAR 2023 presents the first standalone recommendations for imaging in crystalline arthropathies: 5 general principles and 10 practical recommendations, published in 2024. When gout is suspected, …
Read →The musculoskeletal ultrasound course is aimed at physicians and is based on international methodological approaches by EFSUMB (European Course Book, 2nd Ed., 2019; EFSUMB Guidelines Part …
Read →Mastering musculoskeletal ultrasound (MSK-US) is based on a combination of theoretical training and hands-on practice. International educational guidelines are set by EFSUMB (European Course Book, Guidelines) …
Read →Ultrasound of the foot allows for the diagnosis of Morton's neuroma and plantar fasciitis. For neuroma, the Mulder's maneuver (mediolateral compression of the forefoot) with plantar …
Read →According to AIUM 2023, a complete elbow ultrasound protocol is structured into 4 zones: anterior, medial, lateral, and posterior. Orthogonal scans along the long and short …
Read →A practical ultrasound protocol for the wrist is structured by anatomical zones: dorsally — 6 extensor compartments, palmarly — the carpal tunnel and Guyon's canal, followed …
Read →For the adult hip joint, ultrasound according to AIUM 2023 is a targeted examination of the symptomatic area with documentation of joint effusion, synovial changes, tendons, …
Read →The practical protocol for ankle joint ultrasound is structured around 4 zones: anterior, lateral, medial, and posterior, with separate assessment of tendon sheaths, ligaments, and joint …
Read →Ultrasound identifies epicondylitis ('tennis/golfer's elbow') as tendinosis of the common extensor (lateral) or flexor (medial): a thickened hypoechoic tendon with surface bowing and disrupted fibrillar structure; …
Read →In ultrasound-guided injections and blocks, the in-plane (long-axis) approach provides visualization of the entire needle, including the tip, and is preferred in most situations. The out-of-plane …
Read →In gout, ultrasound reveals the double contour sign (urate deposition on the surface of hyaline cartilage — 'urate icing'), tophi ('wet clump of sugar'), and echogenic …
Read →Ultrasound assessment of synovitis in rheumatoid arthritis combines grayscale mode analysis and power Doppler using the standardized consensus EULAR-OMERACT scale. The physician's task is to identify …
Read →Graf's ultrasound of the hip joints is a standardized method for assessing the development of a newborn's joint. On a standard coronal section, the α angle …
Read →Ultrasound of the median nerve is an accurate and rapid method for diagnosing carpal tunnel syndrome. The key criterion is the increase in cross-sectional area (CSA), …
Read →Ultrasound of the Achilles tendon allows differentiation between tendinosis, partial and complete tears, as well as enthesopathy. Key indicators include hypo/anechoic zones in partial tears, tendon …
Read →Anisotropy is one of the most common artifacts in MSK ultrasound: when the beam deviates by just 5° from perpendicular, tendons, ligaments, or nerves become hypoechoic …
Read →Knee joint ultrasound is performed according to a systematic protocol that includes the assessment of the extensor apparatus (quadriceps tendon, patella, patellar tendon), medial and lateral …
Read →A full-thickness tear of the supraspinatus muscle presents as an anechoic/hypoechoic defect across the entire thickness and width of the tendon with retraction and flattening of …
Read →Ultrasound of the shoulder joint is performed according to a standardized protocol rather than a targeted regional approach, as pain is often diffuse or referred. A …
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