ARRS 2022 Abstracts


E2127. Ouch! Use of Musculoskeletal Ultrasound to Evaluate Acute Tendon Injury
  1. Jonathan Lee; Henry Ford Health System
  2. Chad Klochko; Henry Ford Health System
  3. Samantha Summers; Henry Ford Health System
  4. Carrington Martin ; Henry Ford Health System
  5. Rylee Rivier; Henry Ford Health System
  6. Nadra Al-Tahiri; Henry Ford Health System
  7. Joseph Craig; Henry Ford Health System
Acute tendon tears are a common injury affecting a wide population from young professional athletes to the elderly. Depending on the type of injury, expedited surgical intervention might be required to retain function or improve patient outcomes. Musculoskeletal ultrasound is a noninvasive and cost effective modality to assess integrity of the myotendinous junctions and distal tendons. The sonographic images can provide valuable information that can inform the surgical decision process. Proper use of musculoskeletal ultrasound may obviate the need for more expensive imaging modalities such as MRI or CT.

Educational Goals / Teaching Points
The goal of this exhibit is to review normal musculoskeletal sonographic appearance and technique for imaging the long head of the biceps tendon, distal biceps tendon, pectoralis major tendon, distal triceps tendon, extensor mechanism of the knee, proximal hamstring tendons, and Achilles tendon as well as the flexor and extensor tendons of the hand. Identification of tears of these tendons using ultrasound as well as a discussion of the relevant surgical findings will be reviewed, and cross-sectional imaging will be provided in select cases to aid in the anatomic understanding.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This presentation will review the correct approach for the key tendinous structures with cross-sectional correlation as applicable. We also review the correct patient positioning and ultrasound maneuvers to identify anatomic landmarks under normal and pathologic conditions. Dynamic sonographic images will also be provided to help demonstrate normal anatomy as well as the key pathology of the tendon disruption and degree of retraction. Additional secondary signs will be reviewed including hyperemia and increased fluid within the tendon defects.

Musculoskeletal ultrasound imaging is a viable tool to evaluate tendon injury in the acute setting. This presentation has reviewed the proper imaging techniques for normal tendons as well as key surgically relevant findings in the cases of acute tendinous injury. The sonographic information can aid in expedited intervention and improved patient outcomes.