Picture List

Figure 1

Rheumatoid arthritis

Suprapatellar pouch

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Suprapatellar longitudinal scan in neutral position with relaxed (A) and contracted (B) quadriceps muscle

Knee joint effusion. Enlargement of the suprapatellar pouch is detectable only after contraction of the quadriceps muscle. f = femur; p = upper pole of the patella; t = quadriceps tendon; + = synovial fluid.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 2

Psoriatic arthritis

Suprapatellar pouch

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Suprapatellar longitudinal (A) and transverse (B) scans

Exudative synovitis of the knee. Marked joint cavity widening due to a huge amount of synovial fluid (+). More than 100 ml of synovial fluid were aspirated. f = femur; p = upper pole of the patella; t = quadriceps tendon.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 3

Psoriatic arthritis

Lateral recess

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Lateral transverse scan

Proliferative synovitis of the knee joint. Marked joint cavity widening due to both synovial hypertrophy (*) and synovial fluid (+). f = femur; p = lateral edge of the patella.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 4

Rheumatoid arthritis

Suprapatellar pouch

Power Doppler US using a Logiq 9 (General Electrics Medical Systems, Milwaukee, WI) with a linear 9 MHz probe and a Doppler frequency of 6 MHz.

Suprapatellar longitudinal scan in neutral position with relaxed quadriceps muscle.

Proliferative synovitis of the knee joint with obvious intra-articular power Doppler signal. f = femur; p = upper pole of the patella.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 5

Osteoarthritis

Knee joint

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Suprapatellar longitudinal scan

"Dry" knee. Enthesophyte (arrowhead) and osteophyte (arrow) of the upper pole of the patella. f = femur; p = upper pole of the patella; t = quadriceps tendon.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 6

Osgood-Schlatter disease

Patellar tendon

Power Doppler US using AU5 "Harmonic" (Esaote Biomedica, Genova, Italy) with a linear 10-14 MHz probe and a Doppler frequency of 7 MHz

Longitudinal scan at the distal insertion of the patellar tendon into the anterior tibial tuberosity

Marked thickening of the distal part of the patellar tendon with intra-tendinous power Doppler signal. tt = anterior tibial tuberosity; t = patellar tendon.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 7

Chronic gout

Knee joint

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Suprapatellar longitudinal scan with knee flexed

The deposition of monosodium urate crystals on the cartilage surface generates abnormal reflectivity (arrows) of the superficial margin which is independent of the angle of insonnation. f = femur; p = upper pole of the patella; t = quadriceps tendon.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 8

Osteoarthritis

Femoral cartilage

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Suprapatellar transverse scan with knee in maximal flexion

The main pathologic findings are the loss of the transparency of part of the cartilage (*) and the circumscribed thinning of the cartilage layer (arrow). f = femur.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 9

Osteoarthritis

Femoral cartilage

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Infrapatellar transverse scan with knee in neutral position

Note the irregularity of the sub-chondral bone and the marked thinning (arrow) of part of the cartilage layer. f = femur.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 10

Osteoarthritis

Femoral cartilage

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Anterior suprapatellar (A) and infrapatellar (B) transverse scans

Marked thinning of the medial aspect of the femoral trochlea (arrows), detectable in both acoustic windows. f = femur.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 11

Osteoarthritis

Femoral cartilage

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Anterior suprapatellar transverse (A) and longitudinal (B) scans with knee in maximal flexion

Marked irregularity of the sub-chondral bone profile (arrows). No signs of knee inflammation. f = femur; p = upper pole of the patella.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 12

Osteoarthritis

Knee joint

Grey scale US using a Logiq 9 (General Electrics Medical Systems, Milwaukee, WI) with a linear 9 MHz probe

Anterior longitudinal scan of the medial femoral condyle with knee in maximal flexion.

Extended view of the medial femoral condyle showing diffuse thinning of the cartilage layer. f = medial femoral condyle; t = tibia.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 13

Osteoarthritis

Knee joint

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Medial longitudinal scan

The arrows indicate large osteophytes. f = femur; t = tibia.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 14

CPPD disease

Knee joint

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Medial longitudinal scan

The arrowhead indicates calcification of the superficial part of the medial meniscus. f = femur; t = tibia.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 15

Post traumatic knee pain

Medial collateral ligament

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Medial longitudinal scan at the proximal part of the collateral ligament

Partial rupture of the medial collateral ligament (L). The arrow indicate discontinuity of the "fibrillar" pattern. f = medial femoral condyle.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 16

CPPD disease

Popliteal fossa

Grey scale US using AU4 "Idea" (Esaote Biomedica, Genova, Italy) with a linear 7.5-10 MHz probe

Posterior medial longitudinal (A) and transverse (B) scans

Popliteal cyst. The arrowheads indicate hyperechoic spots floating in the anechoic synovial fluid. f = femur.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 17

Osteoarthritis

Popliteal fossa

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Posterior medial longitudinal scan

Large popliteal cyst. Enlargement of the gastrocnemius-semimembranous bursa is mainly due to synovial tissue hypertrophy (*). g = gastrocnemius; + = synovial fluid.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.

Figure 18

Acute gout

Suprapatellar pouch

Grey scale US using a Diasus (Dynamic Imaging, Livingstone, UK) with a linear 5-10 MHz probe

Suprapatellar transverse scan

Knee joint effusion. Sonographic guided aspiration. f = femur; t = quadriceps tendon; arrow = tip of the needle; + = synovial fluid.

Meenagh G, Iagnocco A, Filippucci E, Riente L, Delle Sedie A, Bombardieri S, Valesini G, Grassi W.