The first check is probe angle. Anisotropy happens when the sound beam isn’t perpendicular to the tendon. A healthy tendon can look dark simply because of angle. Gently heel-toe or tilt the probe—if the dark area brightens quickly, it’s anisotropy…
Start by tightening the image so Doppler is working as efficiently as possible. Zoom in on the tendon, decrease depth, and make the Doppler box as small as you can over the area of interest. A smaller box improves sensitivity…
The cartilage interface sign appears in tendon imaging when a tendon tear exposes articular cartilage and fluid sits directly against it. Ultrasound then shows a bright echogenic line at the cartilage surface, which serves as an indirect sign of missing…
On ultrasound, inflammation isn’t something you see directly. Instead, you infer it by looking for hyperemia, which means increased blood flow on Doppler. When a structure shows Doppler signal that normally shouldn’t, it suggests the tissue is more biologically active…
The key difference is inflammation versus chronic structural change. In active bursitis, Doppler shows increased signal in the bursal walls, reflecting active inflammation. The bursa is also more likely to be painful with sonopalpation, even if the amount of fluid…
Nerves and tendons can look similar at first, but they behave differently on ultrasound. In short axis, a nerve has a honeycomb appearance—little black holes on a white background, reflecting dark fascicles surrounded by bright connective tissue. A tendon looks…
Tendinosis is defined by three common gray-scale findings: the tendon is thickened, hypoechoic, and shows loss of normal fibrous echotexture. Instead of clear, parallel fibers, the tendon often looks fuzzy or smeared, reflecting chronic structural change rather than an acute…
Scanning both sides gives you a built-in reference for what’s normal for that person. Size, thickness, and echotexture vary widely between individuals, so a single image can be misleading without comparison. Seeing the opposite side helps you decide whether a…
Zooming the image makes small but important details easier to see when measuring a nerve. Without zoom, the perineurial border can look faint or broken, which makes it harder to trace accurately and increases the chance of over- or under-estimating…
When measuring a nerve’s cross-sectional area (CSA), trace just inside the bright connective rim, not around it. That bright rim represents the perineurium, and including it will overestimate the nerve size. In short axis, freeze the image where the nerve…
