Tendons, ligaments, bursa - #3

Components of extremity MSK

• Bone Surface​

          articular and non-articular​

• Muscle​

pennate​

• Tendon​

       fibrillar sonographic signature​

       musculotendinous junction​

• Meniscus/ Discoid (abnormally thickened) tissue​

• Ligament​

• Bursa​

• Nerves​

• Synovium​

• Articular cartilage

Pennate muscle pattern

fan shaped (feather like)

parallel to bone

Tendons are the attachment of ______ to _________

muscle to bone

tendons have _______ fibers which are _____ - cord like 

collagenous 

rounded 

collagenous fibers of the tendon have flat sheets that are called _________ and have no

aponeuroses

blood flow

synovial sheath may or may not surround the

tendon

synovial sheath has a ______ layer of fluid which makes it easier to visualize 

double 

Tendons connect ______ to ______ and have _______ sheath in areas of _______ such as in the wrist

muscle to bone

synovial sheath

friction

3 tendons without synovial sheath

achilles

patellar

prox gastrocenmius

paratenon 

outer layer of tendon made of loose connective tissue 

epitendineum

dense connective tissue surrounding the tendon

MSKUS allows dynamic imaging and ____ ___ ______ comparison s

side to side

a normal tendon is _____ in thickness and echogenicities 

normal 

when looking at a tendon you should identify echogenic _______ that respresent the _________ fibers to confirm imaging of tendon

fascicles

collagen

the echogenic facicles /collagen fibers run _____ to long axis of tendon

parallel

modality of choice for tendons 

MRI 

bicep tendon

P = patella

T = tibia

Patellar tendon in middle connect both patella and tibia

also helps connect quad muscles to knee and allow leg to straighten

tendon insertion site is called the 

enthesis 

injury can ________ insertion site/enthesis

thicken

Fibrocartilage at enthesis looks

• Avascular​

• Hypoechoic triangular area ​

• 1 cm​

• Mistaken for pathology

ligaments connect 

bone to bone 

ligaments are ____ and ________

thin

superficial

measurement and echogenicity of ligament

2-3mm

hypoechoic band

similar appearance to tendons

sonography techniques fro ligaments 

stand off pad

long imaging only 

Ligament

synovial sheets are seen in the ____ space

bursa

what is a bursa 

Small ‘sacs’  filled with viscous, synovial fluid surrounding muscles, tendons, and ligaments

Bursa fluid allows fro

movement

communication bursa interacts with ______ _______

joint space

Bakers cyst in seen in what bursa

communicating 

How is non communication bursa different from communicating

it DOES NOT interact with joint space

ex: prepatellar bursa