Ultrasonography of Elbow joint

1. MSKS- Elbow

21. ELBOW

35. • Ganglion-
⮚Simple-Anechoic, thin wall, no CF; post ac enhancement.
⮚Complex- multilocular, thick wall—arise from tendon, tendon sheath, ligament,
joint, bone,- stress of these structure causes mucin production.
• Giant cell tumor- well defined, hypoechoic, homogenous, post ac enhancement,
internal vascularity- arise from tendon sheath
• Hemangioma (capillary cavernous)- well defined, hypoechoic, solid, rubbery,
compressible, high vascularity, low resistance flow)
• Peripheral nerve sheath tumor- Schwanoma, neurofibroma, malignant –
hypoechoic , heterogenous,internal vascularity, post ac enhancement, peripheral
nerve continuity.
⮚Ecentric- Schowanoma
⮚Central- Neurofibroma
• Lipoma- SC or intramuscular- ill defined, elongated, echogenic or hypoechoic to
sc, echogenic internal septation

71. Some Terms

75. • Hematoma- no flow, Acute- anechoic less than 6 hrs, then heterogenous hypoechoic--contained low internal echogenicity with a
sheath, suggesting alternation of hypoechoic and hyperechoic areas.
• Hemangioma- show internal vascularity
• Seroma-plasma leakage in post op condition
• Effusion- Effusion is swelling that happens when fluid leaks out of a vein, artery, lymph vessel, or synovial membrane into the
surrounding tissue. This causes the tissue to expand, or swell--compressible
When effusion happens in a joint — commonly the knee — excess fluid can pool in a part of the joint called the synovial
cavity…Non compressible .ex fluid in joint space or bursa
• Synovitis- Synovial proliferation and inflammation—(vascularity +)
• Tenosynovitis - Inflammation of tendon sheath causes synovial proliferation with or without tendinosis-thickening and
hypoechoic ex. De quervain tenosynovitis
• Tendinitis- Acute inflammation of tendon- thickening, hypoechoic with vascularity ex.calcific tendinitis
• Tendinosis- Chronic inflammation or degenerative change
• Tendinopathy-tendon thickening, loss of normal fibrillary pattern with hypoechogenicity.
• Enthesopathy----enthesis—enthesitis- inflammation of the tendon, ligament at the attachment site with the bone.
• Rheumatoid arthritis- synovial proliferation and inflammation, tenosynovitis, bony erosion.
• Osteoarthritis -Irregularity of bony surface due to osteophytes, joint effusion and thickening of joint capsule. Ex 1st MPJ
• Psoriatic arthritis - Joint effusion, synovial proliferation, tenosynovitis (effusion of tendon sheath), and erosion of bone contour --
associated with psoriasis
• Gout - hyperechoic surface of hyaline cartilage (double contour sign), hyperechoic spots and bands within soft tissues, a
“snowstorm” appearance of synovial effusion, and bone erosion Intraarticular bodies

137. Gout (most common in 1st MTP Joint)

139. Dr. Tansena Akhter

144. Hematoma

145. • Hematoma- no flow, Acute- anechoic less than 6 hrs, then
heterogenous hypoechoic--contained low internal echogenicity with
a sheath, suggesting alternation of hypoechoic and hyperechoic
areas.
• As the clotting process begins, the hematoma may become diffusely
hyperechoic and may appear as an irregularly marginated complex
cystic mass with thickened hyperechoic walls, mural nodules, or
irregularly thickened but avascular internal septations.Chronic
hematomas may be anechoic, markedly hypoechoic with diffuse
homogeneous low‐level internal echoes and a subtle fluid‐debris
level, or diffusely mildly echogenic. However, chronic organizing
hematomas may occasionally have a solid rather than a cystic
appearance.

146. Hematoma