Standardised. knee. scanning of the. Basic pathology. Nemanja Damjanov. University of Belgrade Institute of Rheumatology
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1 Standardised scanning of the Nemanja Damjanov University of Belgrade Institute of Rheumatology knee Basic pathology
2 Disclosure Lecturer: Pfizer, Abbvie, Roche, MSD, Boehringer-Ingelheim, Gedeon Richter, Takeda, Investigator: Pfizer, Abbvie, Roche, MSD, Advisor: Pfizer, Abbvie, Roche, MSD, Boehringer- Ingelheim,
3 Knee anatomy - bones 1 1. Femur 2 2. Patella 3. Tibia 3 4. Fibula 4
4 Knee anatomy sesamoid bones Sesamoid bones in heads of gastrocnemius muscle 1 Patella 2 Fabellae Sesamoid bone of popliteal muscle
5 Knee anatomy - joints Femorotibial joint Patellofemoral joint Superior tibiofibular joint Fabellofemoral joint
6 Knee anatomy large synovial cavities Synovial membrane cavities
7 Knee anatomy small synovial cavities Prepatellar bursa Superficial infrapatellar bursa Profound infrapatellar bursa Lateral gastrocnemius head bursa
8 Knee anatomy small synovial cavities
9 US examination
10 US examination Anterior longitudinal scan
11 Suprapatelar longitudinal scan Subcutaneous fat tissue Quadriceps muscle & tendon Suprapatellar fat pad Suprapatellar recess Prefemoral fat pad
12 Suprapatelar longitudinal scan Subcutaneous fat tissue Quadriceps tendon Suprapatellar fat pad Suprapatellar recess Prefemoral fat pad
13 Suprapatelar longitudinal scan
14 Suprapatelar longitudinal scan RA PsA OA Gaut
15 Suprapatelar transverse scan QT Femur Suprapatellar fat pad Suprapatellar recess Prefemoral fat pad
16 Suprapatellar transverse scan n.p.
17 Suprapatellar transverse scan m.f.
18 Suprapatellar transverse scan m.f. Sonographic signs of cartilaginous changes Normal 1. reduced sharpness of the cartilage superficial margin 2. loss of clarity (transparency) of the cartilage
19 Suprapatellar transverse scan m.f. Sonographic signs of cartilaginous changes Normal 3. thinning of the cartilaginous layer 4. increased intensity of the deep cartilage margin 5. irregularities of subchondral bone profile.
20 Sonographic signs of cartilaginous changes 1 Normal reduced sharpness of the cartilage superficial margin 2 2. loss of clarity (transparency) of the cartilage 3. thinning of the cartilaginous layer increased intensity of the deep cartilage margin 5. irregularities of subchondral bone profile. 5 4
21 Suprapatellar transverse scan m.f. CPPD = calcium pyrophosphate dihydrate deposition
22 Juxtapatellar scan
23 Juxtapatellar scan
24 Juxtapatellar scan
25 Infrapatellar longitudinal scan
26 Infrapatellar longitudinal scan
27 Infrapatellar longitudinal scan Hoffa fat pad Patellar tendon Superficial infrapatellar bursa Profound (deep) infrapatellar bursa
28 Infrapatellar longitudinal scan Normal patellar tendon
29 Infrapatellar longitudinal scan Hoffa fat pad
30 Infrapatellar transvesal scan
31 Infrapatellar longitudinal scan Jumper s knee
32 Infrapatellar longitudinal scan Jumper s knee
33 Sinding Larsen Johansson disease - Chronic traction on the inferior pole of the patella - Small avulsed pieces of cartilage or bone US signs: - fragmented lower pole of the patella - hyperechoic Hoffa's fat - tendinitis with hypervascularity
34 Osgood-Schlatter disease Tibial tuberosity Tibial tuberosity
35 Osgood-Schlatter disease Tibial tuberosity
36 Infrapatellar bursitis PT HF * HF T tibia Deep infrapatellar bursa between the tibia surface and Hoffa s fat pad PT In special conditions like trauma or inflammation it becomes visible on US. T
37 Parapatellar transverse scan Patella Femur
38 Knee anatomy - ligaments Anterior knee Medial Colateral Ligament (MCL) Posterior knee Lateral Colateral Ligament (MCL)
39 Knee anatomy - ligaments Anterior Cruciate Ligament (ACL) LM Medial meniscus LM Anterior knee Posterior Cruciate Ligament (PCL) Posterior knee
40 Knee anatomy - tendons Quadriceps tendon Patellar Tendon (ligament)
41 Knee anatomy - tendons Lateral gastrocnemius tendon Popliteus tendon
42 Knee anatomy - tendons Iliotibial band semitendinosus, gracilis, sartorius tendons
43 Medial longitudinal scan Medial Collateral Ligament (MCL)
44 Lateral longitudinal scan Lateral collateral ligament (LCL)
45 Lateral longitudinal scan Iliotibial band Iateral colateral ligament
46 Lateral longitudinal scan Iliotibial band syndrome
47 Lateral longitudinal scan Iliotibial band syndrome
48 Osteophytes A step-up bony prominence at the end of the normal bone contour, or at the margin of the joint. They usually have a posterior acoustic shadow.
49 Osteophytes A step-up bony prominence at the end of the normal bone contour, or at the margin of the joint. * * They usually have a posterior acoustic shadow.
50 Meniscus
51 Posterior transverse scan Mh Gastrocn. m. Lh Gastrocn. m. IN PV PA
52 Posterior transverse scan Semimembranosus t. Semitendinosus t. Baker Cist Mh Gastrocnemius m. Tibia Medial condile Ishiadic n. Popliteal vein Popliteal artery
53 Posterior transverse scan Semimembranosus t. Semitendinosus t. Tibia Medial condile
54 Posterior medial transverse & longitudinal scan
55 Posterior medial longitudinal scan
56 Medial longitudinal scan Meniscus
57 Medial longitudinal scan Meniscus
58 Posterior lateral longitudinal scan Parameniscal cyst.
59 Take home messages Knee is frequently affected joint. US examination is part of the comprehensive clinical approach to the patient. US examination alows fast, reliable dynamic insight in soft tissue pathology. Some structures can not be completely evaluated (meniscus, cruciate ligaments, bones).
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Mohammad Ashraf. Abdulrahman Al-Hanbali. Ahmad Salman. 1 P a g e
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Human Anatomy Biology 351
Human Anatomy Biology 351 Lower Limb Please place your name on the back of the last page of this exam. You must answer all questions on this exam. Because statistics demonstrate that, on average, between
Joints: Part B 10/30/14. Classification of Synovial Joints. Six types, based on shape of articular surfaces: Plane Joints
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Apply this knowledge into proper management strategies and referrals
1 2 3 Lower Extremity Injuries Jason Kennedy, M.D. Disclosures I have no financial/ industry disclosures. Objectives Identify common lower extremity injury patterns in the child and adolescent Apply this
Gluteal region DR. GITANJALI KHORWAL
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