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Musculoskeletal ultrasound of the knee

Mederic M Hall, MD
Sathish Rajasekaran, MD
Section Editor
Karl B Fields, MD
Deputy Editor
Jonathan Grayzel, MD, FAAEM


The extra-articular structures of the knee are readily accessible for detailed sonographic evaluation. While intraarticular evaluation is incomplete, many structures can be partially visualized, and the examination often provides useful clinical information.

This topic will describe a systematic approach to complete sonographic evaluation of each knee quadrant. Topics devoted to knee pain and specific knee conditions are found separately. (See "Approach to the adult with knee pain likely of musculoskeletal origin" and "Anterior cruciate ligament injury" and "Posterior cruciate ligament injury" and "Medial collateral ligament injury of the knee" and "Meniscal injury of the knee" and "Knee bursitis" and "Osgood-Schlatter disease (tibial tuberosity avulsion)".)


Physical principles and technology of ultrasound are reviewed separately. (See "Basic principles and safety of diagnostic ultrasound in obstetrics and gynecology".)

Below, the advantages and limitations of the ultrasound examination of the knee are reviewed; the general advantages and limitations of musculoskeletal ultrasound are discussed separately. (See "Musculoskeletal ultrasound of the shoulder", section on 'Uses, advantages, and limitations of shoulder ultrasound' and "Musculoskeletal ultrasound of the ankle and hindfoot".)

Ultrasound evaluation of the knee offers many benefits. Its superior spatial resolution allows for detailed evaluation of tendon, ligament, and nerve disorders that may not be possible with other imaging modalities. Mechanical complaints of snapping or clicking can be assessed dynamically in real time, and the location of pain can be correlated with precise anatomic structures by palpation with the ultrasound transducer (ie, sonopalpation). Orthopedic hardware does not produce artifacts in ultrasound images, allowing for evaluation of surrounding structures for signs of impingement, irritation, or injury. However, although many knee structures are easily accessible for sonographic examination, intraarticular structures are not, and this inherent limitation of ultrasound technology means that other imaging modalities may be required to assess the knee joint thoroughly.

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Literature review current through: Nov 2017. | This topic last updated: Nov 20, 2015.
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