Knee (Anterior and Lateral)

Knee:

I had chance to do some self scanning on my own knee. For background, I'm without any major knee pathology or complaint. I am pain free. I anticipate a friend with PFPS vs. lateral ligamtenous strain next week and I'm trying to work on my normal findings anticipating pathology in hers.

Again, like the elbow, I used the ESSR guidelines. These are by no means comprehensive, but they are simple, straightforward, and an excellent framework for a brief bedside evaluation. I performed peri-patellar anterior, lateral, and medial knee exam. I did not perform posterior knee.

I'll walk you through the highlights.

Here was the starting point. Knee flexed to 20-30 degrees, probe placed over suprapatellar quadriceps tendon. You'l note femur as the hypoechogenic structure at the bottom. Directly above is the Vastus Intermedius. Directly above this is a very bright (hyperechogenic) structure representing the quadriceps tendon (from the rectus femoris located superior). Flanking the tendon on both sides is the Vastus Lateralis and Vastus Medialis.





I switched to long view of the quadriceps tendon as it approaches the patella. You'll note a cavity beneath the quad tendon, but above the femur. This is the suprapatellar synovial recess.



Here quadriceps hits patella.


Below I hightlighted the structures worth spotting. Orange represents quadriceps tendon, blue is synovial suprapatellar recess, yellow is prefemoral fat pad.

Next I moved to the Femoral Trochlea. I'm a sucker for wavy bones (like humerus) and the cartilage overlying. Note that this one is unique in that the knee is put into full flexion. You'll note the overlying quadriceps tendon assuming the V shape overlying the trochlea.

Infrapatellar scan for the patellar tendon (notable distinct structure in superior portion of screen). Beneath this lies Hoffman's Fat pad. I didn't find this to particularly satisfying view of the fat pad.


Part two coming shortly with LCL / MCL.