Learning objectives
1.
To illustrate the normal sonographic anatomy of the lateral knee (LK).
2.
To describe and depict the various pathologies affecting the LK.
3.
To outline relevant sonographic guided interventions for the evaluated pathologies.
Background
LK comprises of a complex arrangement of muscles,
tendons and ligaments providing primary restraint against varus angulation.
The LK can be divided into two main functional compartments:
Anterolateral compartment: Fig. 1
Joint Capsule
Iliotibial band (ITB)
Hoffas fat pad
Posterolateral compartment: Fig. 2
Biceps femoris (BF)
Fibular collateral ligament (FCL)
Arcuate ligament (AL)
Popliteus muscle-tendon unit (PMT)
Popliteofibular ligament (PFL)
Fabellofibular ligament (FFL)
Posterolateral capsule [1]
The fibular head anchors the posterolateral corner providing attachments to several structures.
[2] Fig. 3
LK anatomy has been...
Findings and procedure details
ULTRASOUND (US) EVALUATION OF LK–
Patient position -Supine with leg internal rotated and knee slightly flexed. Fig. 4
Probe - High-frequency transducer.[5]
LK CHECKLIST:
The main five structures evaluated are the iliotibial band,
fibular collateral ligament,
the biceps femoris tendon,
popliteus tendon and the lateral meniscus.
(For each structure,
a table showing the probe positioning and normal appearance of that structure will be provided,
along with their image references.)
1) ILIOTIBIAL BAND(ITB) Table 1 Fig. 5 Fig. 6 Fig. 7
2) FIBULAR COLLATERAL LIGAMENT(FCL) Table...
Conclusion
Recently for musculoskeletal therapeutics,
the onus has shifted to minimally invasive procedures owing to their ease of performance and reduced patient morbidity,
with surgery reserved for recalcitrant cases.
Radiologists play a pivotal role in both diagnostics and guided interventions with imaging allowing direct disease visualisation and targeted therapy.
Sonography being a radiation safe,
easily available and cost-effective modality is excellent in this regard.
References
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2014;34(2):496-513.
Jacobson JA.
Musculoskeletal ultrasound and MRI: which do I choose? Semin Musculoskelet Radiol.
2005;9:135–149.
Daftary AR,
Karnik AS.
Perspectives in ultrasound‑guided musculoskeletal interventions.
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2015;25:246‑60.
Alves TI,
Girish...
