Appendix Musculoskeletal Ultrasound Imaging Protocols

Shoulder Date: History:

Biceps—long head ______Subscapularis ______Infraspinatus ______Supraspinatus ______

Posterior Labrum ______Spinoglenoid Notch ______ACL & Acromion ______Fluid: SASD1 Joint ______Bicipital Sheath ______Other ______Cortical Margin2 ______

Impingement: Supraspinatus ______Subcoracoid ______Other:

Additional comments:

Sonographer

Note: Tendon tears should be measured in orthogonal planes, distance from key landmarks, e.g., interval for supraspinatus tears, involvement of musculo- tendinous junction, muscle belly atrophy/fat infiltration, description tear, e.g., partial, delaminating, etc.

1Subacromial-subdeltoid bursa. 2Greater and lesser tuberosities.

329 330 Appendix Elbow Date: History:

Joints Space: Effusion Synovial Proliferation Cartilage Cortex Coronoid fossa Radial fossa Radial neck recess1 Olecranon fossa

Anterior Tendon Brachialis Median Radial Nerve

Medial Ulnar Collateral Medial Epicondyle

Lateral Radial Collateral Ligament Lateral Epicondyle

Posterior Tendon Olecranon/Fossa Ulnar Nerve

Additional comments:

Sonographer

Note: Usually a dedicated study performed as per clinical request and/or symptoms.

1Includes the proximal radioulnar joint. Musculoskeletal Ultrasound Imaging Protocols 331 Wrist Date: History: Wrist Volar

Flexor Tendons: FDS/FDP/FPL FCR/FCU Flexor Retinaculum

Nerves: Median N Ulnar N

Dorsal Compartments: 1 2 3 4 5 6

Scapholunate Ligament Lunotriquetral Ligament

Triangular Fibrocartilage Complex

TFC Ulnar Collateral Ligament Tendon Sheath Extensor Carpi Ulnaris

Joint

Effusion Synovial Proliferation Cartilage Cortex DRUJ Radiocarpal joint Additional comments:

Sonographer

Note: Usually a dedicated study performed as per clinical request and/or symptoms. 332 Appendix Date: History: Joint:

Effusion Synovial Proliferation Cartilage Cortex Anterior Labrum Anterior

Femoral Triangle Tendon and Bursa Sartorius Rectus Femoris Medial

Pectineus Adductor Longus Adductor Brevis Adductor Magnus Gracilis Lateral

Bursae around the Greater Trochanter Tensor Lata Iliotibial Band

Posterior

Gluteus Maximus Gluteus Medius Gluteus Minimus : Semimembranosus Conjoint Tendon Semitendinosus/Biceps Femoris Sciatic Nerve Additional comments:

Sonographer

Note: Usually a dedicated study performed as per clinical request and/or symptoms. Musculoskeletal Ultrasound Imaging Protocols 333 Date: History: Anterior Patellar Retinaculum ACL1 Superior Joint Recess Bursae Medial Semitendinous Gracilis Sartorius Medial Collateral Ligament Medial (Anterior Horn and Body) Lateral Iliotibial Band Fibular Collateral Ligament Biceps Femoris (Anterior Horn and Body) Common Peroneal Nerve Posterior Semimembranosus Gastrocnemius: Medial Head Lateral Head PCL ACL Bursae Posterior Horns Menisci: Medial Lateral Popliteal Fossa Vessels Joint: Effusion Synovial Proliferation Cartilage Cortex Additional comments:

Sonographer Note: Usually a dedicated study performed as per clinical request and/or symptoms. 1ACL: may not be identifiable in all patients. 334 Appendix and Date:

History: Joint: Effusion Synovial Proliferation Cartilage Cortex Anterior Tibialis Anterior Extensor Hallucis Longus Extensor Digitorum Longus Posteromedial Tibialis Posterior Flexor Digitorum Longus Flexor Hallucis Longus Flexor Retinaculum Posterolateral Extensor Retinaculum Posterior Achilles Retrocalcaneal Bursa Retroachillean Bursa Kagar’s Fat Pad Anterior Tibiofibular Distal Interosseous Membrane Lateral: Anterior Talofibular Calcaneofibular Posterior Talofibular1 Medial: Deltoid Additional comments:

Sonographer

Note: Usually a dedicated study performed as per clinical request and/or symptoms.

1May not be identifiable in all patients. Musculoskeletal Ultrasound Imaging Protocols 335 Soft Tissue Mass: Upper/Lower Limb

Date: History:

Site1

Overlying Skin

Size AP Longitudinal Transverse

Shape Contour2

Internal Echotexture3

Compressible4

Posterior Acoustic Enhancement

Doppler

Extension5

Surrounding Fluid

Surrounding Tissues (Displacement/Invasion)

Examine adjacent joint if in close proximity

Additional comments:

Sonographer

Notes

1. Plane, e.g., subcutaneous, intramuscular, intermuscular. 2. Contour, e.g., smooth, lobulated, ill-defined, etc. 3. In/homogeneous, hyper/hypo/anechoic, calcification, air, vascularity. 4. Compressibility: also assess with Doppler. 5. Extension, e.g., along nerve or fascial plane. 336 Appendix Synovitis Protocol: Wrist and

Date: History:

Distal Radioulnar Joint.

1 2 3 4 5

MCPJ

PIPJ

DIPJ

Radiocarpal Joint Space Midcarpal Joint Space Carpometacarpal Additional comments:

Sonographer

Notes 1. Usually a dedicated examination limited to the symptomatic joints is performed and agreed upon with referring clinicians. 2. Assess joints in longitudinal and transverse planes, volar and dorsal aspects, and, where accessible, the lateral joint recesses. 3. Assess the following: (a) fluid and synovium: compressibility and displacement, power Doppler; (b) articular cartilage; (c) cortex: smooth/irregular/erosions. 4. Overlying tendons and sheaths. Musculoskeletal Ultrasound Imaging Protocols 337 Synovitis Protocol: Ankle and Foot

Date: History:

Ankle Joint Intermetatarsal Joint Spaces

1 2 3 4 5

MTPJ

PIPJ

DIPJ

Tarsometatarsal Joint Spaces Additional comments:

Sonographer

Notes:

1. Usually a dedicated examination limited to the symptomatic joints is performed and agreed upon with referring clinicians. 2. Assess joints in longitudinal and transverse planes, volar and dorsal aspects, and, where accessible, the lateral joint recesses. 3. Assess the following: (a) fluid and synovium: compressibility and displacement, power Doppler; (b) articular cartilage; (c) cortex: smooth/irregular/erosions. 4. Overlying tendons and sheaths. Index

A attachment site of, 159, 186 magnetic resonance imaging of, Abductor digiti minimi muscle, ultrasound evaluation of, 174, 243, 251 126, 131, 249, 250, 253, 273, 193, 194 ultrasound evaluation of, 275 Adductor magnus muscle 256–279 accessory, 298, 299 anatomy of, 157, 160, 162, 163, anterior ankle, 257–260 Abductor digiti minimi tendon, 245 180, 181, 183, 184, 186, anterior joint, 260–261 , 245, 187–188, 193, 194, 201, bones and joints of the foot, 249, 250, 252, 253, 273, 275 205, 206 277–279 Abductor pollicis brevis muscle, attachment site of, 159, 186, 203 clinical indications for, 110, 124, 126, 135, 137, 145 ultrasound evaluation of, 193, 243–244 Abductor pollicis brevis tendon, 194, 196 of the dorsum foot, 276–277 130 Adductor pollicis brevis tendon, imaging protocol for, 279 Abductor pollicis longus muscle, 130 muscle compartments, 257 106, 110, 123, 126, 127, 135, Adductor pollicis muscle, 123, 124, posterior ankle, 264 137, 145, 295 126, 132, 135 posterolateral ankle, 264–272 Abductor pollicis longus tendon, Adductor transverses hallucis postomedial ankle, 261–264 137, 138 muscle, 274, 276 of the foot, 272–276 Abscess, soft-tissue, 179 Adductor tubercle, 206 technical aspects of, 244 Acetabular ligament, transverse, Anatomical snuff box, 122 Annular ligament, 81 164 Anconeus epitrochlearis muscle, Arcade of Frohse, 112, 299 Acetabular notch, 158 87, 293 Arcuate ligament, 202 Acetabulum, 158 , 55–75 anatomy of, 56, 62, 78, 85, 87, anatomy of, 56–65 anatomy of, 225, 230–231, 250 104, 110 anterior (flexor) muscle as muscle insertion site, 235 function of, 62 compartment, 59–62 ultrasound evaluation of, 223, bones, 57–58 insertion site of, 82, 106 237, 245, 259, 272–273 fascia, 59, 63 as lateral elbow landmark, Acromioclavicular joint magnetic resonance imaging 97–98 anatomy of, 22, 30–31 of, 61, 111 Aneurysm, popliteal, 199–200 instability of, 47 muscles and tendons, 58–63 Anisotropy, in ultrasound, 15–16 ultrasound evaluation of, 47 , 64–65, 285–294 of the knee, 211 Acromioclavicular ligament, posterior (extensor) muscle of the posterior cruciate 30–31, 48 compartment, 59, 61, ligament, 219, 220 Acromion 62, 63 of the semimembranosus anatomy of, 22, 31 quadrilateral space, 63 tendon, 217, 218, 219 fusion of, 47 surface anatomy, 56–57 of the , 42, 43 ultrasound evaluation of, 47, 48 triangular (interval) space, 63 Adductor aponeurosis, 130 of the tibialis posterior tendon, ultrasound evaluation of 262 Adductor brevis muscle, 160, 162, anterior compartment, 67–69 163, 174, 183, 184, 188, 193, Ankle and foot, 243–280 , 65–66 194 anatomy of, 244–256 indications for, 55 , 180 blood vessels and nerves, 256 nerves, 70–74, 285–294 Adductor hallucis muscle, 249, bones and joints, 245–247 posterior compartment, 70 254, 274 ligaments, 254–255 technical aspects of, 55–56 Adductor insertion avulsion muscles and tendons, 244, technique, 65 syndrome, 192–193 247–252 Arthritis nerves, 307–310 of the elbow, 77 anatomy of, 156, 157, 160, 162, retinaculae, 255–256 septic, 179 163, 181, 183, 184, 186, sole of the foot, 249, 252–254 Articular disc, 145 187–189 surface anatomy, 244–245 Articularis genu muscle, 186, 203

339 340 Index

Axillary , anatomic Brachial fascia, 63 Carpal flexor tunnel, 131 relationship to brachial , 61 Carpal ligaments plexus, 319, 323, 324, 325 anatomy/function of, 56, 57, 60, extrinsic dorsal, 139–140 Axillary nerve 62, 68, 78, 84, 104, 286 transverse, 294, 295 anatomy of, 286, 287–288 function of, 58, 62, 84 Carpal rows, proximal and distal, location of, 63 innervation of, 59, 62 123 ultrasound evaluation of, 289 origin and insertion sites of, 58, Carpal tunnel, 140–142, 294 82, 106 Carpal tunnel syndrome, 140–142, B ultrasound evaluation of, 65, 69, 297 Bankart lesions, 52 90, 91, 92 Carpometacarpal joint, capsule of, Biceps brachii muscle Brachial plexus, 313–326 126 action/function of, 84 anatomy of, 314–319 Cartilage, anatomy and ultrasound anatomical variations to, 62 axillary level, 317, 319 evaluation of, 13–15 anatomy of, 26, 56, 57, 60, 62, branches, 317 Cervical artery, transverse, 324 78 cords, 314, 315, 316 Circumflex innervation of, 59, 62 divisions, 314, 315, 316, 317 anterior, 34 long head of, 27, 28, 58, 60, 61, infraclavicular level, 317, posterior humeral, 63, 286, 289 62, 65, 67 318, 319 Circumflex vein, posterior humeral, origin and insertion sites of, 58, interscalene level, 317, 319 63 82, 106, 203 root level, 317–319 Clavicle, 22, 23, 26 short head of, 26, 28, 58, 60, 61, roots, 314, 315, 316, 317 Collateral ligament bursa, medial, 62, 65, 67, 203 supraclavicular level, 317, 207 ultrasound evaluation of, 65, 67, 318, 319 Collateral ligaments. See also 69 surface anatomy, 315 Ulnar colateral ligament Biceps brachii tendon, 67, 68, 84, trunk, 314, 315, 316, 317 of the elbow, 80, 81–82, 85, 95, 85, 86 magnetic resonance imaging of, 96 Biceps dislocation, 28 313 lateral , 161, 162, symmetrical, 316 of the ankle, 269–270 181, 183, 185 ultrasound evaluation of fibular, 205 action/function of, 202 at axillary level, 323 of the knee, 201, 202, 203, anatomy of, 157, 201, 205, 206, imaging protocols in, 205, 214, 216 225 323–324 medial conjoined tendon of, 301 indications for, 313 of the elbow, 81–82 long head of, 163, 177, 187, at infraclavicular level, 323, of the knee, 201, 203, 205, 189, 195, 196, 197 324 206, 212–213, 214 origin and insertion sites of, at interscalene level, 322 of the wrist and hand, 148–150 159, 189, 195, 202 at root level, 319, 320–322 Common extensor tendon, 85–86, short head of, 159, 186, 187, at supraclavicular level, 323, 87, 93–94 189, 196, 197, 301 324 Common flexor tendon sheath, 296 ultrasound evaluation of, 5, 195, technical aspects of, 314 Computed tomography 196, 206, 215, 216 technique, 319–320 arthrography, of rotator cuff Biceps femoris tendon, 177, 202, muscle tears, 52 240 anatomy of, 56, 78, 104, Condyles. See also Epicondyles Biceps groove, 57 109–110, 123 lateral Biceps tendon(s) function of, 107 of the femur, 181, 182, 201, anatomical variations to, 62 origin and attachment site of, 203 anatomy of, 28, 57, 68 106, 107 of the tibia, 203 distal, 82, 84, 92, 93, 94, 104 ultrasound evaluation of, 109, medial, of the femur, 181, 182, location of, 34 114, 116 201, 203 pathology of, 21 Brachioradialis tendon, 95 Cooperberg, P. L., 3 ultrasound evaluation of, 9 Bursae. See also names of specific Coracoacromial ligament, 30, 31, , 60, 61, 78 bursae 48, 49 Bicipital groove, 9, 28, 33, 34, 35, anatomy and ultrasound 36, 291 evaluation of, 12–13 action/function of, 58 Bicipital sheath, 28 aspiration and injection of, 22 anatomy of, 26, 27, 60, 61, 62 Bicipitoradial bursa, 92 Bursitis, 77, 179, 213, 223 innervation of, 59, 62 Biopsy, ultrasound-guided origin and insertion sites of, 58 in the leg, 223–224 C ultrasound evaluation of, 65, 68 of shoulder soft-tissue masses, , 245, Coracobrachialis tendon, 68, 69 22 255, 269, 270 Coracoclavicular distance, synovial, of the knee, 200 Calcaneonavicular ligaments, 255, assessment of, 47 Bones. See also names of specific 271 Coracoclavicular ligament, 27, 30, bones Calcaneus bone, 226, 230, 245, 31, 48 anatomy and ultrasound 246, 250 Coracohumeral ligament, 27, 28, evaluation of, 13, 14 Calf, nerves of, 307–309 30, 48, 49 Brachial artery Canal of Alcock, 306 Coronoid fossa, 79, 91–92 anatomic relationship to median Capitate bone, 124, 143, 144 Cruciate ligaments nerve, 70, 71, 72, 291 Capitellum bone, 58, 79, 90, 91 anterior, 201, 203, 220, 221 anatomy of, 286 Carotid artery, 321 ganglion cysts associated with, ultrasound evaluation of, 69 Carotid sheath, 320 200 Index 341

posterior, 201, 203, 219, 220 magnetic resonance imaging anatomy of, 85, 104, 110, 123, anisotropy of, 219, 220 of, 86 127, 295 Cubital (bicipitoradial) bursa, 88 muscles and tendons, 82–87 origin and insertion sites of, 107 Cubital fossa, 78 nerves, 87 Extensor digiti minimi tendon, anterior, 104 surface anatomy, 78 85–86 , 286, 292–293 synovial lining, 80 Extensor digitorum brevis muscle, normal variant of, 293 ultrasound evaluation of, 88–99 227, 246, 250, 276, 278 Cubital tunnel retinaculum, 293 anterior approach in, 89–93 Extensor digitorum brevis tendon, Cuboid bone, 245, 246, 278–279 imaging protocols, 99 244, 247 Cuneiform bones, 245, 246, indications for, 77 Extensor digitorum longus, 248, 278–279 lateral approach in, 93–96 250, 259, 260 Cutaneous nerves medial approach in, 96–97 Extensor digitorum longus muscle lateral femoral, 304 posterior approach in, 97–99 anatomy of, 203, 205, 225, 227, medial, 286 technical aspects of, 7 228, 229, 230, 258 posterior, 190 Endoneurium, 284 insertion site of, 203, 227 upper lateral, 288 Enthesopathy, of the Achilles ultrasound evaluation of, Cysts tendon, 223 233–234, 235, 236 Baker’s (popliteal), 199, Epicondyles Extensor digitorum longus tendon, 207–208, 306 lateral 247, 257, 258, 278 differentiated from of the elbow, 7, 58, 78, 85, 96 Extensor digitorum muscle semimembranosus of the femur, 182 anatomy of, 56, 85, 104, 110, tendon, 217, 219 of , 104 123, 127, 295 differentiated from of the humerus, 79, 104 origin and insertion sites of, 107 thrombophlebitis, 3 medial ultrasound evaluation of, 109, ruptured, 199–200 anatomic relationship to ulnar 115 ultrasound evaluation of, 217, nerve, 293–294 Extensor digitorum tendon, 85, 244 219 of the elbow, 56–57, 58, 78, Extensor hallucis brevis longus, ganglion, 200, 286 81–82 250 cruciate, 219 of the femur, 182 Extensor hallucis brevis muscle, meniscal, 200 of the forearm, 104, 105 246 paralabral, 21–22, 45, 286 of the humerus, 79, 104, 105 Extensor hallucis longus muscle parameniscal, 305 Epicondylitis, 77 anatomy of, 225, 228, 229, 248, Epineurium, 283, 284–285 250, 308 D Extensor apparatus, attachment site ultrasound evaluation of, 233, De Flaviis, L., 3 of, 124 236, 260 , 250, 254, 255, Extensor carpi radialis brevis, 104 Extensor hallucis longus tendon, 268, 270–271 Extensor carpi radialis brevis 244, 247, 257, 258 Deltoid muscle muscle Extensor hood, 130 action/function of, 28–29, 58, 59 action/function of, 107 , 106, 110, anatomy of, 22, 23, 26, 28–29, anatomy of, 56, 85, 104, 110, 124, 127, 135, 137 31, 56, 57, 58–59, 60 123, 295 Extensor indicis tendon, 137, 138 origin and insertion sites of, 58 origin and insertion sites of, Extensor pollicis brevis muscle, ultrasound evaluation of, 50, 107, 124 106, 110, 124, 126, 127, 135, 65–66 ultrasound evaluation of, 109, 137 Deltoid tendon, insertion site of, 57 114, 116 Extensor pollicis brevis tendon, Deltoid tuberosity, 57, 58–59 Extensor carpi radialis brevis 125, 137, 138 Digital nerves tendon, 137, 138 Extensor pollicis longus muscle, common palmar, 296 Extensor carpi radialis longus 106, 124, 125–126, 127, 135, common plantar, 308 muscle 137 dorsal, 295 anatomy of, 56, 60, 85, 104, Extensor pollicis longus tendon, proper palmar, 296 109–110, 295 122, 125, 137, 138 Digitorum longus peroneus tertius ultrasound evaluation of, 109, Extensor radialis longus muscle, muscle, 233 114, 116 110 Distal interphalangeal joint (DIP), Extensor carpi radialis longus Extensor retinaculum, 110, 146, 147 tendon, 95, 137, 138 124–125, 127, 259–260 Donald, D. G., 3 Extensor carpi radialis muscle, 115 inferior, 230, 250, 259, 260, Dorsal hood injuries, 148 Extensor carpi radialis tendon, 85 276–277 Dorsalis pedis artery, 256, 258 Extensor carpi ulnaris muscle superior, 250 Dorsalis pedis vein, 258 action/function of, 107 External oblique muscle, 157, 181 Dupuytren’s contracture, 130 anatomy of, 56, 104, 110, 123, Dussik, K. T., 3 127 F origin and insertion sites of, Fabellofibular ligament, 202, E 107, 124 215–216 Elbow, 77–101 ultrasound evaluation of, 109 , 182 anatomy of Extensor carpi ulnaris tendon, Fasciculus, 6 bones, 79–80 85–86, 137, 138, 139, 143 Fasciitis bursae, 88 in triangular fibrocartilage necrotizing, 179 deep fasciae, 88 imaging, 145 plantar, 243–244 joint capsule, 68, 80 Extensor digiti minimi muscle Fasica, anatomy and ultrasound ligaments, 80, 81–82 action/function of, 107 evaluation of, 7–8 342 Index

Fat pads relationship to ulnar nerve, 111, Flexor pollicis longus muscle anterior, of the ankle joint, 261 112 action/function of, 108 of the elbow, 79, 80 ultrasound evaluation of, 109 anatomy of, 110, 126, 127, 136, Hoffa’s infrapatellar, 205 Flexor carpi ulnaris tendon, 87, 130 295 Kager’s, 232, 237 Flexor digiti minimi brevis muscle, innervation of, 294 Femoral artery, 156, 193 126, 136, 137, 249, 254 origin and insertion sites of, 82, common, 173–174, 186, 301 Flexor digiti minimi muscle, 131 106, 108, 124, 136 Femoral condyles, lateral and Flexor digitorum accessorius ultrasound evaluation of, 109, medial, 225 muscle, 246, 253, 263 114, 137, 146 Femoral neck, 168 Flexor digitorum brevis longus Flexor profundus digitorum Femoral nerve muscle, 253 muscle, 132 anatomy of, 156, 167, 190, 287, Flexor digitorum brevis muscle, Flexor retinaculum 301, 303 249, 252, 273, 274, 275 anatomy of, 110, 130, 250, ultrasound evaluation of, Flexor digitorum brevis tendon, 255–256, 294–295, 296 303–304 245 medial, 261, 264 Femoral neurovascular bundle, 173 Flexor digitorum longus muscle palmar bowing/displacement of, Femoral triangle, 156–157, 162, accessory, 232 140–142, 296, 297–298 173, 180 anatomy of, 229, 232, 248, 250, ultrasound evaluation of, 261, Femoral vein, 156, 193 252, 308 296, 297–298 common, 173 ultrasound evaluation of, 233, Foot. See Ankle and foot Foot drop, 305 Femur, anatomy of, 201, 203, 301 237–238, 239, 261 Forearm, 103–119 distal, 201 Flexor digitorum longus tendon anatomy of, 104–112 gluteal tuberosity, 182 anatomic relationship to the bones, 105–106 greater and lesser trochanters, lumbrical muscles, compartments, 109–110, 111 157–158, 158, 166, 180, 273–274 muscles and tendons, 182 anatomy of, 249, 250, 253, 262, 106–111 head, 157, 158, 168, 182 263, 276 ultrasound evaluation of, 239, nerves, 111–112, 294–300 intercondylar fossa, 182 261 surface anatomy, 104–105 intertrochanteric line, 182 Flexor digitorum muscle, ultrasound evaluation of lateral and medial condyles, ultrasound evaluation of, 114 indications for, 103 181, 201 Flexor digitorum profundus muscle of the muscle compartments, lateral supracondylar line, 182 action/function of, 108 113–116 medial condyle, 181 anatomy of, 56, 85, 110, 126, technical aspects of, 103–104 medial supracondylar line, 182 286, 295 technique, 112–118 neck, 157–158, 168, 182 innervation of, 294 Foreign bodies, in the wrist and patellar surface, 203 origin and insertion sites of, 82, hand, 121 popliteal surface, 182 106, 108 Fovea capitis femoris, 157 proximal, 157, 181 ultrasound evaluation of, 109, Fractures, 13, 14 shaft, 181–182 114 nondisplaced, of greater spiral line, 182 Flexor digitorum profundus tendon, tuberosity, 21 trochlear cartilage, 211 146, 147 stress, 192–193 Fibrocartilage, 14–15 Flexor digitorum superficialis Fibroma, 243–244 muscle G Fibula action/function of, 108 Gastrocnemius bursa, lateral, 207 action/function of, 226 anatomy of, 56, 85, 86, 104, anatomy of, 203, 225, 226, 246 110, 123, 126 anatomy of, 205, 206, 225, 229, distal, 245 origin and insertion sites of, 82, 248 ultrasound evaluation of, 224, 106, 108 lateral and medial heads, 201, 235 ultrasound evaluation of, 109, 230, 235, 238, 301 Fibular collateral ligament, lateral, 114 attachment site of, 186, 203, 227 205 Flexor digitorum superficialis ultrasound evaluation of, 217, Flexor accessorius tendon, 249, 253 tendon, 87, 146, 147, 294 218, 233, 238 Flexor brevis digiti minimi muscle, Flexor hallucis brevis muscle, 246, Gastrocnemius-semimembranosus 274, 276 249, 253–254, 274 bursa, 207 Flexor carpi radialis muscle Flexor hallucis longus muscle Gastrocnemius tendon, ultrasound action/function of, 108 anatomy of, 229, 232, 248, 253, evaluation of, 217, 218 anatomy of, 56, 85, 86, 104, 308 Gemellus inferior muscle, 161, 110, 123, 127 insertion site of, 227 162, 163, 164, 183, 185, 189 origin and attachment sites of, synovial sheath of, 250 Gemellus superior muscle, 159, 108 ultrasound evaluation of, 233, 161, 162, 164, 183, 185, 186, ultrasound evaluation of, 109, 237–238, 239, 261 187, 189 114 Flexor hallucis longus tendon Gerdy’s tubercle, 187, 195, 203, Flexor carpi radialis tendon, 87, anatomy of, 245, 249, 250, 252, 205 295, 296 253 Glenohumeral joint Flexor carpi ulnaris muscle ultrasound evaluation of, 239, anatomy of, 22, 23 action/function of, 108 262–263, 264 instability of, 31 anatomy of, 85, 86, 104, 110, Flexor longus muscle, 109 range of motion of, 23, 31 123, 126, 286 Flexor pollicis brevis muscle, 124, Glenohumeral ligament, 23, 48 origin and insertion sites of, 108 136, 137 Glenoid, 23–24 Index 343

Glenoid labrum, 16, 31 nerves, 166–167 Iliopsoas bursa, 166, 171 Gluteal fold, 157, 180, 181 surface anatomy, 156–157 Iliopsoas muscle, 162, 168, 183 Gluteal nerve, superior, 164 aspiration of, 159 Iliopsoas tendon Gluteus maximus muscle injection into, 159 anatomy of, 163 anatomy of, 157, 161, 162, 180, magnetic resonance imaging of, anisotropy of, 16 181, 183, 185, 187, 189 155–156, 165 distal, 158 bursae, 166, 174–175 peripheral nerves of, 301–304 snapping of, 156, 172–173 superior fibers, 194–195 stability of, 158, 164 ultrasound evaluation of, insertion site of, 159, 186 ultrasound evaluation of, 169–170, 171, 172 snapping, 195 167–178 Iliopubic eminence, 158, 182 ultrasound evaluation of, 175, anterior approach in, 167, Iliotibial band, 161, 163, 176, 183, 176 168–174 194, 195 Gluteus maximus tendon, 176 clinical indications for, Iliotibial ring, 181 Gluteus medius muscle 155–156 anatomy of, 159, 161, 162, 163, of the femoral triangle, 173 action/function of, 202 164, 183, 185, 187, 189 imaging protocol, 178 anatomy of, 157, 162, 180, 181, bursae, 166, 174–175 internal snapping hip 186, 187, 201, 205, 206, ultrasound evaluation of, 175, syndrome, 172–173 225 183 lateral approach in, 167, origin and insertion sites of, Gluteus minimus muscle, 183, 186 174–175 202, 203 anatomy of, 159, 161, 162–163, of the lateral structures, ultrasound evaluation of, 206, 164, 185, 189 174–175, 176 214 bursae, 166, 174–175 of the medial structures, , body of, 158 ultrasound evaluation of, 175, 173–174 Inferior transverse ligament, 176 of the nerves, 178 227–228 posterior approach in, 167, Infrapatellar bursa action/function of, 202 175–177 deep, 208 anatomy of, 160, 162, 163, 183, of the posterior structures, superficial, 207, 208 184, 186–187, 205, 225 175, 177 origin and insertion sites of, technical equipment for, 156 anatomy of, 22, 23, 24, 26, 27, 202, 203 Hip effusions, 169 32, 56, 60, 286 ultrasound evaluation of, Hoffa’s infrapatellar fat pad, 205, atrophy of, 22 193–194, 206 207 innervation of, 32, 285 Graf, R., 3 Humeral ligament, transverse, 28 Infraspinatus tendon, 27, 43–44 Greater trochanter, 157–158, 175, Humerus differentiated from teres minor 180, 182, 194 anatomy of, 23–24, 31, 57, tendon, 44 Groin, nerves of, 300–304 79–80, 286 Inguinal ligament, 156, 163, 166, Guyon’s canal anatomic and surgical necks, 301 anatomy of, 298 58 Inguinal ring ulnar artery and vein in, 296 anterior border, 57 deep, 157, 181 ulnar nerve in, 298, 299 articular cartilage, 23–24 superficial, 157, 181 ultrasound evaluation of, 117, bony landmarks, 57, 58 Intermalleolar ligament, 255 140, 143 capitulum, 79 Intermetatarsal bursa, 309 Guyon’s canal syndrome, 298 coronoid fossa, 79 Intermetatarsal ligaments, 255, epicondyles, 79, 104, 105 H 271–272 head, 50, 51, 58 Haglund deformity, 223 Interosseous artery, anterior, 294 olecranon fossa, 79 Hamate bone, 124 Interosseous ligaments posterior surface, 57 hook of, 123, 124 extrinsic, 128, 134 radial fossa, 58, 79–80, muscle complex injury, inferior, 226 91–92 195 intrinsic, 133–134 relationship to brachialis Hamstring muscles, 164, 189. See Interosseous membrane, 81, 106, muscle, 68 also Biceps femoris muscle; 109, 235 supracondylar processes, 57 ; action/function of, 226–227 surface anatomy, 56–57 anatomy of, 226–227, 228 tuberosities, 24, 26, 27, 28, Hand. See Wrist and hand relationship to anterior 56, 57, 58–59 Hardware, orthopedic, 180 interosseous nerve, Heel- effect, 33, 34, 35 distal, 14, 90 111–112 Hematoma, posttraumatic, 297 ultrasound evaluation of, 91–92 ultrasound evaluation of, Hernia, muscle, 223, 234 , 123, 125, 238–239 Hill-Sachs defect, 21, 50, 51, 52 131-132, 146 Interosseous muscles Hip, adult, 155–197 Hypothenar hammer syndrome, 298 dorsal, 110, 123, 124, 127, 132, anatomy of, 156–167 136, 137, 246, 276 bones, 182 I palmar, 132, 136, 137 bones and hip joint, 157–159 Iliac crest, 158, 163 plantar, 276, 277 bursae, 166 Iliac fossa, 158 of the sole of the foot, 249 capsule and synovial Iliac spine, posterior superior, 157 transverse, 127 membrane, 159 , 159, 160, 162, 163, Interosseous nerves ligaments, 164, 165, 166 169, 186 anterior, 111–112, 294, 298 muscles and tendons, , 159, 164, 166 posterior, 111, 112, 117, 118, 159–164 Iliopectineal eminence, 173 299, 300 344 Index

Interphalangeal joints, 123, 279 anatomy of, 224–232 Medial cutaneous nerve, 286 Intersection syndrome, 121 accessory muscles, 231, 232 Medial joint space, 97 Intertrochanteric crest, 182 anterior muscle compartment, Medial ligament. See Ulnar Intertrochanteric line, 158, 159, 182 228, 229 colateral ligament Intertubercular groove, 58 bones, 225–226 Median artery Ischial bursa, 166 bursae, 232 persistent prominent, 131 Ischial spine, 158, 182 fascia, 228 thrombosis of, 297 Ischial tuberosity, 157, 177, interosseous membrane, Median nerve 180–181, 182, 196 226–227 anatomic relationship to brachial , 164 lateral muscle compartment, artery, 70, 71, 72 Ischium, 158, 182 228, 229 anatomy of, 64, 87, 111, 126, ligaments, 227–228 131, 286, 287, 290–291, J muscles and tendons, 294–197, 295, 296 Joint aspiration, ultrasound-guided, 228–232 bifid, 131, 141, 142 200 nerves, 232 compression of, 297 posterior muscle cross-sectional diameter of, 141, K compartment, 228, 229, 142 Kager’s fat pad, 232, 237 230–232 during flexion/extension of the Kiloh-Nevin syndrome, 297 surface anatomy, 224–225 fingers, 131, 140 Knee, 199–221 magnetic resonance imaging of, in Guyon’s canal, 142 anatomy of 223, 231 location of, 122 bones, 201, 203 ultrasound evaluation of maximum flattening ratio of, bursae, 207–208 anterior compartment, 141 cartilage, 206–207 233–234 ultrasound evaluation of, 70–72, joint recesses, 207 bursa, 240–241 87, 90, 92, 94, 114, 116, ligaments, 201–205 imaging protocols in, 241 117, 121, 140–142, 284, muscles, 202, 204, 205–206 indications for, 223–224 296, 297–298 nerves, 208, 304–307 interosseous membrane and in proximal forearm, 297 surface anatomy, 200–201 ligaments, 238–239 variations in course of, 291 tendons, 206 lateral compartment, 234–235 Menisci magnetic resonance imaging of, nerves, 224, 239–240 lateral 199, 200, 203 posterior compartment, anatomy of, 205, 206–207 ultrasound evaluation of 235–238 ultrasound evaluation of, 216, anterior knee, 208, 209–211 technical aspects of, 224 219–220 bursae, 211 technique, 233 medial imaging protocols, 221 Lesser trochanter, 157–158, 166, anatomy of, 206–207, 219 indications for, 199–200 180, 182 ultrasound evaluation of, 212, joint recesses, 210, 219 Levator ani muscle, 159 213, 219 lateral knee, 208–209, Ligament of Struthers, as median Meniscofemoral ligament 214–217 nerve compression site, 291 anatomy of, 201–202 medial knee, 208–209, Ligaments. See also names of ultrasound evaluation of, 211–214 specific ligaments 211–212 posterior knee, 217–221 anatomy and ultrasound Meniscotibial ligament technical equipment for, 200 evaluation of, 10 anatomy of, 201–202, 207 Knee effusions, 200, 207 Ligamentum teres muscle, 158, 164 ultrasound evaluation of, Knee pain, 199 Linea aspera, 181, 182, 187–188 211–212 Lisfranc’s ligament, 255, 271–272 Meniscus homologue, 134, 145 L Lister’s tubercle, 13, 14, 122, 123, Metacarpal bones, 123, 124, 146 Labrum 124, 125–126, 127, 137, 139, Metacarpal ligament, dorsal, 128 acetabular, 158 145 Metacarpophalangeal joint, 123, anatomy of, 31–32, 158 Longus coli muscle, 320 146 anterior, ultrasound evaluation Loose bodies, intraarticular , 245, 246–247, of, 46 in the ankle and foot, 243 250, 277–279 anterior superior in the elbow, 77, 91 Metatarsophalangeal joint, 279 anatomy of, 168–169 in the hip, 156 Mobile wad, 109–110, 116 ultrasound evaluation of, 156 Lumbrical muscles, 110, 126, 132, Muscle compartments, disruption of, 52 137, 249, 253, 273–274 identification of muscles fluid within, 45 Lunate bone, 124, 141, 144 within, 238 injuries to, 21–22 Lunate triquetrum, 124 Muscle fibers, 4 posterior, ultrasound evaluation Lunotriquetral ligament, 121, 129, Muscles. see also specific muscles of, 44–45 134, 138–139, 140, 143 anatomy and ultrasound tears of, 45, 46 appearance of, 4–7 ultrasound evaluation of, 44–45, M cardiac, 4 46, 156, 158 Magnetic resonance arthrography, in contracted and relaxed states, Lateral patella retinaculum muscle, for rotator cuff tear 5–6, 234 205 evaluation, 51–52 identification within muscle Latissimus dorsi muscle, 22, 23, Malleoli compartments, 238 56, 289 lateral, 225, 230, 244, 250, 264, skeletal, 4 Leg, 223-241. See also Ankle and 265, 266, 308 smooth, 4 foot medial, 225, 244, 245, 250 Musculocutaneous nerve Index 345

anatomy of, 62, 286, 287, 290 insertion site of, 159, 186 ultrasound evaluation of, 290 ultrasound evaluation of, anatomy of, 187, 201, 205, 207, 173–174, 193 208, 225, 230 N Pectineus tendon, 174, 193 insertion site of, 189 Navicular bone, 245–246, 250, 278 Pectoralis major muscle, 22, 23, ultrasound evaluation of, 213 Nerve blocks, ultrasound-guided, 28, 289 Phalanges, 124, 147, 148, 245 302 Pectoralis muscle, 51 Phrenic nerve, 320 Nerve fascicles, 283, 284 Perineurium, 284–285 Nerve fibers, 283 Periostitis, traction, 192–193 anatomy of, 159, 161, 162, 163, Nerves. See also Peripheral Peripheral nervous system, 164, 183, 185, 186, 187 nervous system; names of 283–311 ultrasound evaluation of, 189 specific nerves magnetic resonance imaging of, Pisiform bone, 122, 123, 124, 126 anatomy and ultrasound 283 Pisometacarpal ligament, 126 evaluation of, 11–12 nerves of Plantar digital nerve, common, 253 differentiated from tendons, 116 around the knee, 304–307 (aponeurosis), 252, Neuroma, Morton’s, 272, 273, 309, of the foot, 309–310 253, 272–273, 274 310 of the lower limb, 300–310 pathology of, 243–244 of the , 285–300 O normal sonohistology of, anatomy of, 229, 230, 231, 235, Obturator externus, 185 283–285 248 Obturator externus muscle, Peritendonitis, of the Achilles insertion site of, 186, 203, 227 anatomy of, 159, 161, 162, tendon, 223 ultrasound evaluation of, 233, 164, 183, 186, 189 Peroneal nerve, 308 237 Obturator internus muscle, common, 187, 190 Plantaris tendon, ultrasound anatomy of, 159, 161, 162, anatomy of, 205, 208, 224, evaluation of, 237 163, 164, 183, 185, 186, 189 232, 239, 287, 301, Obturator nerve, 190 304, 307, 308 lateral, 253, 308 cutaneous branch of, 301 ultrasound evaluation of, medial, 308 Olecranon, 58, 97, 105–106, 286 214–215, 216, Popliteal fossa, 181, 201, 224 Olecranon bursae, 88 239–240, 304–305, Popliteofibular ligament, 202, 215, Olecranon fossa, 79, 97, 98 307 217 Opponens digiti minimi muscle, deep, 247, 256, 308 , 249 131–132, 136, 137 superficial, 208 action/function of, 202 , 124 ultrasound evaluation of, 240 anatomy of, 229, 232 Os acromiale, 24, 47, 48 Peroneal retinaculum, 245, 267 origin and insertion sites of, Osborne’s fascia, 293 superior and inferior, 230, 250, 202, 203, 227 Osteomyelitis, 179 256 ultrasound evaluation of, 206, Os trigonum, 245 Peroneal tendons, 228, 230 233 Peroneal trochlea, 245, 265 Popliteus tendon P Peroneal tunnel, 304 anatomy of, 202 Palmar carpometacarpal ligaments, Peroneus brevis muscle relationship with popliteus 128 anatomy of, 227, 228, 229, 230, recess, 219–220 Palmaris brevis muscle, 136, 137 246, 248, 250 ultrasound evaluation of, 215, , 86–87, ultrasound evaluation of, 233, 217 104, 109, 123 234, 235, 236, 265 Prepatellar bursa, 207, 208 Palmaris longus tendon, 87 Peroneus brevis tendon Profundus flexor retinaculum Parapatellar fossa, medial, 181 anatomy of, 245, 252 muscle, 126 Paratenon, 10, 231 differentiated from avulsed bone Profundus tendons, 133 Patella bone fragments, 260 Pronator quadratus muscle, 106, anatomy of, 181, 183, 186, 200, ultrasound evaluation of, 235, 110, 114 201, 203, 225 265, 266 Pronator quadriceps muscle, ultrasound evaluation of, 210, Peroneus longus muscle innervation of, 294 211 anatomy of, 205, 225, 230, 233, , 85 Patella ligament, 205 246, 248, 250 action/function of, 108 Patella retinaculum muscle, medial, insertion site of, 203, 227 anatomic relationship to median 205 synovial sheath of, 250 nerve, 291 Patellar ligament, 201, 203, 225, ultrasound evaluation of, 233, anatomy of, 56, 60, 78, 85, 86, 230 234–235, 235 104, 110 Patellar tendon Peroneus longus tendon origin and insertion sites of, 82, anatomy of, 200, 205, 206 anatomy of, 245, 252 106, 108 insertion site of, 224, 225 ultrasound evaluation of, 235, ultrasound evaluation of, 109, tears of, 200 236, 265, 266, 273 114 ultrasound evaluation of, 200, Peroneus quadratus muscle, Pronator teres tendon, 87 209–210, 234 accessory, 232 Proximal interphalangeal joint Patellofemoral ligament, 205, 206 Peroneus quadratus tendon, 228, (PIP), 146, 147 medial, 203 266–267 , 159, 186 Peroneus tertius muscle, 228, 229, Psoas major tendon, 163 anatomy of, 157, 160, 162, 163, 246, 248, 250 Psoas muscle, 160, 169 164, 173–174, 181, 183, Peroneus tertius tendon, 244, 247, Pubic crest, 156 184, 186, 187, 193 257 Pubic tubercle, 156, 158 346 Index

Pubis, 192–193 groove for extensor ultrasound evaluation of, 177, body of, 158, 182 digitorum, 105 178, 196–197, 302–303, inferior ramus of, 158, 182 groove for extensor indicis, 306 superior ramus of, 158, 174, 182 105 Semimembranosus muscle , 164 groove for extensor pollicis action/function of, 202 Pudendal canal, 306 longus, 105 anatomy of, 157, 160, 162, 163, Pudendal nerve, 306–307 head, 79, 105 181, 183, 186, 189, 201, Pudendal nerve block, 307 interosseous membrane, 106 205, 225, 301 Pulley systems, 126, 129, 133 neck, 79, 105 origin and insertion sites of, injuries to, 146, 148 styloid process, 104 159, 186, 202, 203 ultrasound evaluation of, ultrasound evaluation of, 91, ultrasound evaluation of, 177, 146–148 114, 115, 116 195, 196, 197, 206 Pyomyositis, 179 Rectus abdominis muscle, 157, 181 Semimembranosus tendon anatomy of, 189 Q anatomy of, 157, 159, 160, 162, differentiated from Baker’s Quadratus femoris muscle 163, 180, 181, 183, 184, cysts, 217, 219 anatomy of, 161, 162, 164, 183, 186, 201, 205–206 ultrasound evaluation of, 217, 185 insertion site of, 159, 186, 203 218, 219 insertion site of, 159, 186 musculotendinous junction of, Semimembranosus-tibial collateral ultrasound evaluation of, 189 191 ligament bursa, 207, 208 Quadratus plantae, 273, 275 ultrasound evaluation of, 169, Semitendinosus muscle Quadriceps femoris tendon, 181, 170, 206 action/function of, 202 186, 201, 205, 225 Rectus femoris tendon, 191, 192 anatomy of, 157, 160, 162, 163, Quadriceps muscles, 205–206 Rectus muscle, 202, 205 183, 184, 186, 201, 225, Quadriceps tendon Retroachillean (subcutaneous 301 anatomy of, 183, 186, 191 calcaneal) bursa, 232, 240, origin and insertion sites of, anisotropy of, 211 267 159, 186, 202, 203 palpable, 180 Retrocalcaneal bursa, 232, ultrasound evaluation of, 177, tears of, 200 240–241, 267 196, 197 ultrasound evaluation of, 189, Rotator cable, 43, 48 Semitendinosus tendon, ultrasound 200, 209 Rotator cuff evaluation of, 219 Quadrilateral space, 63, 288 interval, 30, 41 Shin, 224 axillary nerve in, 288, 289 muscles, 23 Shoulder pathology, 21 anatomy of R tears, 51–52 acromioclavicular joint, , 295 tendons, 23, 29 30–31 Radial collateral ligament, 81, 82, bones, 23–24 95, 96 S bursae, 29 Radial fossa, 58, 79–80, 91–92 Sacrotuberous ligament, 187 coracoid arch, 30 Radial groove, 57, 74 Sagittal band, 126 labrum, 31–32 Radial neck recess, 91–92 Saphenous nerve, 190, 301, 307 muscles, 24–29 Radial nerve surface anatomy, 22–23 anatomic relationship to radial anatomy of, 157, 159–160, 160, anterior instability of, 51 groove, 57, 74 162, 163, 180, 181, 183, dislocation of, 23 anatomy of, 63, 64, 87, 112, 184, 186, 187, 202 posttraumatic pain in, 21 286, 287, 291–292, 295, origin and insertion sites of, ultrasound evaluation of, 33–52 299–300 159, 186, 202, 203 acromioclavicular joint, 47 susceptibility to injury, 65 ultrasound evaluation of, 169, acromion, 47, 48 ultrasound evaluation of, 73–74, 170, 206 clinical indications for, 21–22 87, 93, 117–118, 292, 300 Scaphoid bone, 124, 129 deltoid muscle, 33 Radial styloid process, 122 fractures of, 122, 145 imaging protocols, 52 Radial tuberosity, 92, 95, 105 tubercle of, 123 infraspinatus muscle, 33 Radial tunnel, 299 Scapholunate ligament, 121, 129, infraspinatus tendon, 43–44 Radiocapitellar joint, 79, 90 133, 134, 138–139, 140, 143 ligaments, 47–48 Radiocapitellar joint space, 89, 90 Scaphotriquetral ligament, 141, long head biceps tendon and Radiolunotriquetral ligament, 143, 144 sheath, 33–36 143, 144 dorsal, 141 posterior labrum, 44–45 Radioscaphocapitate ligament, Scapula, 22, 23, 32, 56 spinoglenoid notch, 44, 143, 144 Scapular ligament, 285 45–46 Radioscapholunate ligament, 143 Scapular notch subacromial impingement, Radiotriquetral ligament, 141 anatomy of, 32, 288 48–50 Radioulnar bursa, 88 suprascapular nerve , 33 Radioulnar joint compression around, 286 subscapularis tendon, 36–38 distal, 128, 129 Scapular spine, 22, 23, 24, 26, 32, , 33, 40, proximal, 79, 80 288 42 Radius bone, 90, 124, 129, 141, Sciatic nerve supraspinatus tendon, 38–40, 144 anatomy of, 163, 166–167, 177, 41, 43 anatomy of, 105 178, 187, 190, 204, 208, technical equipment for, 22 distal, 123 232, 287, 300–302 , 33 dorsal tubercle, 105 bifurcation of, 197 teres minor tendon, 43, 44 Index 347

Snapping hip syndrome, 156, differentiated from rotator cable, magnetic resonance imaging 172–173, 179 43, 48 of, 188 ultrasound evaluation of, 38–40, muscles and tendons, accessory, 231, 232 41, 48–49 182–189 anatomy of, 225, 230, 235, 248 anisotropy in, 42, 43 nerves, 190, 301–304 insertion site of, 203, 227 in Crass position, 38, 39 surface anatomy, 180–181 ultrasound evaluation of, 233, in limited range of motion, peripheral nerves of, 301–304 238 39–40 ultrasound evaluation of, Sonoarthrography, of rotator cuff in modified Crass/Middleton 190–197 tears, 51 position, 38, 39, 41 anterior group muscles, 190, Spinal nerves, C7, anterior ramus Supraspinatus tendon dynamic 191–192 of, 321 impingement test, 48–50 bursae, 196 Sural nerve, 306 Spinoglenoid arch, 31 clinical indications for, Sustentaculum tali, 245, 263, 271 Spinoglenoid notch, 285 179–180 Synovitis suprascapular nerve compression imaging protocol for, 197 in, 286–287, 288 of the elbow, 77 lateral and gluteal group ultrasound evaluation of, 44, of the knee, 200 muscles, 190, 194–195 45–46, 286 pigmented villonodular (PVNS), medial group muscles, 190, Spiral groove, radial nerve 243 192–194 entrapment in, 292 of the shoulder, 52 nerves, 196–197 Stener’s lesion, 122, 150 posterior group muscles, 190, Sternocleidomastoid muscle, 321, T 195–196 322 Talocrural joint, 245 technical equipment for, 180 Subacromial impingement, Talofibular ligament Thrombophlebitis, differentiated ultrasound evaluation of, anterior, 255, 269–270 from Baker’s cyst, 3 48–50 posterior, 255, 269 Thrombosis, deep venous, 199–200 Subacromial-subdeltoid (SASD) Talonavicular ligament, superior, Thumb bursa, 13, 29, 39–40, 48–49, 255, 271 50 Talus bone, 226, 245, 246, 259 extensor tendons of, 129, 130 Subcoracoid bursa, 29, 36 , 264 ulnar collateral ligament of, 130, Subcutaneous olecranon bursa, 88 Tarsus bone, 245 149–150 Subsartorial canal, 180 Tendinosis Tibia Subscapularis bursa, 13, 26, 28 of the Achilles tendon, 223 action/function of, 225 Subscapularis muscle, 24, 26, 27, calcific, aspiration and anatomy of, 201, 203, 225, 230, 28, 60 dissolution of, 22 246, 308 Subscapularis tendon, 26, 28, of the knee, ultrasound anterior intercondylar fossa, 36–38 evaluation of, 200 203 Subtendinous olecranon bursa, 88 of the area, 179 medial malleolus, 226 Superficialis tendon, 133 Tendons. See also names of shaft, 225–226 Superior extensor retinaculum, 230 specific tendons surface anatomy, 224 Superior transverse scapular anatomy and ultrasound ultrasound evaluation of, ligament, 32, 288 evaluation of, 8–10 224, 235, 236, 239, 259, Supinator muscle in contracted and relaxed states, 261 action/function of, 107 234 Tibial artery anatomy of, 78, 110, 295 differentiated from nerves, 116 anterior, 244, 247, 256 origin and insertion sites of, 82, Tenosynovitis posterior, 240, 245, 256, 308 106, 107 de Quervain’s, 121 Tibial condyle, medial, 225 ultrasound evaluation of, 109, infective, 179 Tibialis muscles 115 Tensor fasciae latae muscle anterior Supracondylar process, 57, 291 anatomy of, 157, 161, 162, 181, anatomy of, 201, 205, 225, Suprapatellar recess, 207, 209 183, 185, 186, 187, 189, 228, 229, 230, 246, Suprascapular artery, 32, 45, 288 227 248, 250 Suprascapular ligament, ultrasound insertion site of, 227 ultrasound evaluation of, 233, evaluation of, 48 ultrasound evaluation of, 175, 234, 235, 236 Suprascapular nerve, 32, 285–287, 194 posterior 288 , 26, 27, 56, 60, anatomy of, 229, 230, 232, differentiated from 286 248, 308 suprascapular blood Teres minor muscle, 24, 26, 27, 32, vessels, 46 56, 60, 286 insertion site of, 203 Suprascapular nerve impingement, Teres minor tendon, 27 synovial sheath of, 250 21 differentiated from infraspinatus ultrasound evaluation of, 233, Supraspinatus muscle tendon, 44 237–238, 239 anatomy of, 22, 23, 24, 26, 27, ultrasound evaluation of, 43, 44 Tibialis tendons 31 , 123, 131 anterior, 244, 247, 258 atrophy of, 22 Thigh, adult, 179–197 posterior, 245, 249, 250, 252, innervation of, 32, 285 anatomy of, 180–190 261, 262 ultrasound evaluation of, 7, 40, bones, 181–182 differentiated from avulsed 42 bursae, 189 bone fragments, 260 Supraspinatus tendon fascia and compartments, 8, insertion sites of, 264 anatomy of, 27, 28, 31 182 ultrasound evaluation of, 239 348 Index

Tibial nerve Trochlear notch, 106 anatomy of, 157, 201, 202, 205, anatomy of, 187, 190, 208, 232, Trochlear ulnar joint space, 89, 90 225 287, 301, 305–306, origin and attachment sites of, 307–308 U 186, 202, 203 anterior, 208, 232 Ulna bone, 123, 124, 129, 141, 144 ultrasound evaluation of, 159, branches of, 309, 310 anatomy of, 105 206 posterior, 232, 239, 256, 261, coronoid process, 79, 105, Vastus medius muscle, 183 272 106 Vertebrae, cervical ultrasound evaluation of, 239, distal, 139 anatomy of, 318, 319 240, 306, 308–309, 310 groove for extensor carpi ultrasound evaluation of, Tibial tuberosity ulnaris, 105 320–321 anatomy of, 201, 205, 224, 225 head, 105 Volar plate, 126, 147 ultrasound evaluation of, 234 interosseous border, 105 interosseous membrane, 106 Tibial vein, posterior, 240 W olecranon, 58, 105–106 Tibilialis tendons Wrist and hand, 121–151 posterior border, 105 anterior, 257, 258, 259, 260 anatomy of, 122–134 styloid process, 105 posterior, 245–246 adductor pollicis muscle, 132 supinator notch, 105 Tibiocalcaneal ligament, 254–255, bones, 123–124 trochlear notch, 79, 105, 106 268 carpal flexor tunnel, 124, tuberosity, 79, 105 Tibiofibular joint, 10, 254, 269 125, 126, 131 ultrasound evaluation of, 91, Tibiofibular ligaments, 245 digital attachments of flexor 114, 115 anterior, 268 tendons, 133 Ulna collateral ligament, 85 anterior inferior, 227, 254, 267 extensor compartment wrist, Ulnar arcuate ligament, 128 interosseous, 268 124–127 Ulnar artery posterior, 267, 268, 269 extensor hood, 130 anatomy of, 126, 295, 296 posterior inferior, 227–228 extrinsic interosseous aneurysm or thrombosis of, 298 Tibionavicular ligament, 268 ligaments, 134 Ulnar collateral carpal ligament, Tibiotalar ligament, 268 finger flexor tendon pulley 126, 128 deep, 268 system, 129, 133 Ulnar collateral ligament, 81–82, posterior, 268 flexor compartment wrist, 85, 96–97, 129, 130, 134, Transverse acetabular ligament, 130 149–150 164 flexor fibrous sheaths, 132 Ulnar nerve Transverse carpal ligament, 294, flexor retinaculum, 126, 130 anatomy of, 64, 85, 87, 112, 295 and fingers, 127–129 126, 286, 287, 292–293, Transverse humeral ligament, 28, hypothenar eminence, 295, 296, 298 34, 47–48 131-132 in Guyon’s canal, 142 Transverse ligament, inferior, interosseous muscles, 132 ultrasound evaluation of, 72–73, 227–228 intrinsic interosseous 87, 98–99, 116–117, 140, Trapezium bone, 123, 124, 126 ligaments, 133–134 293–294, 298–299 Trapezius muscle, 26, 42, 56 Ulnar vein, 296 long flexor tendons and Trapezoid bone, 124 Ulna styloid process, 122 lumbrical muscles, 132 Triangular fibrocartilage complex Ulnohumeral joint, 79 nerves, 294–300 (TFCC), 128, 129, 134, 143, Ulnolunate ligament, 134, 143 surface anatomy, 122–123 145 Ulnotriquetral ligament, 128, 134, synovial flexor sheaths, Triangular ligament, 128 143, 144 132–133 Triangular membrane, 84 dorsal, 141 thenar eminence, 131 Triangular (interval) space, 63 Ultrasound, musculoskeletal thumb, 130 Triceps brachii muscle history of, 3–4 triangular fibrocartilage action/function of, 58, 62 introduction to, 3–17 complex, 134 anatomy of, 57, 62, 78, 87, 106 technological advances in, 3–4 ulnar collateral ligament of lateral head, 56, 58, 60, 61, the thumb and adductor 62, 63, 65, 70, 104 V aponeurosis, 130 long head, 58, 60, 61, 62, 63, Vastus intermedius muscle, 162, magnetic resonance imaging of, 65 183, 184, 191, 192 125 medial head, 58, 60, 61, 62, action/function of, 202 ultrasound evaluation of, 65, 70, 99 origin and insertion sites of, 134–150 innervation of, 62 159, 186, 202, 203 clinical indications for, 121 origin and insertion sites of, 58, ultrasound evaluation of, 206 collateral ligaments, 148–150 62, 82, 106 Vastus intermedius tendon, 192 dorsal approach to the wrist, ultrasound evaluation of, 65, 70, , 162, 163, 134 71 180, 181, 183, 184, 186, 187, extensor tendons, 137–138, Triceps tendon 191 148 distal, 97 action/function of, 202 hands and fingers, 146–148 ultrasound evaluation of, 70, 97, anatomy of, 157, 201, 205, 225 imaging protocols for, 150 98 origin and attachment sites of, ligaments, 138–140 Triquetro-trapezial ligament, 128 159, 186, 202, 203 muscles, 135–137 Triquetrum bone, 124, 129, 139, ultrasound evaluation of, 206 technical equipment for, 122 141, 144 muscle, 162, 163, volar approach in, 140–145 Trochanteric bursa, 166 180, 181, 184, 186, 187–188, volar-ulnar approach in, Trochlea, 58, 79, 211, 245 191–192 143–145