Ultrasonography of tendons

Tendon disorders range from asymptomatic degenerative changes, to inflammation of the peritendinous tissues, to rupture; these disorders are common as a group, particularly among athletes and the elderly. The high resolution of modern ultrasound equipment and the superficial location of most tendons in the body allow the spectrum of tendon abnormalities to be easily depicted with ultrasonography. Specific sonographic criteria for the diagnosis of tendinosis, tendon tears, and tenosynovitis exist, and are summarized in Box 1. Given the high prevalence of rotator cuff disease and the low cost of the shoulder ultrasonography examination relative to MR imaging, requests for shoulder sonography are likely to increase. It is therefore essential to become familiar with this examination. The ankle examination serves as a useful model for tendons in other parts of the body, both as a targeted examination and for the evaluation of very superficial structures.