Download PDF
Semin Musculoskelet Radiol 2000; 4(4): 375-392
DOI: 10.1055/s-2000-13168
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

The Case for Ultrasound of Muscles and Tendons

Bruno D. Fornage
  • Professor of Radiology and Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Also available at
    Permissions and Reprints

ABSTRACT

Ultrasound is a highly sensitive technique that can be conveniently employed in the evaluation of muscle lesions of many types, ranging from neuromuscular diseases seen by neurologists to mass lesions and injuries seen by orthopedists. The technique is perhaps underutilized given its utility in these applications compared with other cross-sectional imaging techniques. Particularly when recent developments, such as extended field of view and color Doppler techniques, are integrated, ultrasound becomes highly attractive in the imaging evaluation of various lesions. This article reviews characteristic ultrasound appearances of various muscle and tendon lesions and discusses various newer techniques and interventional applications.

KEYWORD

Ultrasound - muscles - neoplasm - abscess - biopsy

REFERENCES

  • 1 Fornage B D, Touche D H, Segal P, Rifkin M D. Ultrasonography in the evaluation of muscular trauma.  J Ultrasound Med . 1983;  2 549-554
    PubMedSearch in Google Scholar
  • 2 Fornage B D, Rifkin M D, Touche D H, Segal P M. Sonography of the patellar tendon: preliminary observations.  AJR Am J Roentgenol . 1984;  143 179-182
    PubMedSearch in Google Scholar
  • 3 Fornage B D, Schernberg F L, Rifkin M D. Ultrasound examination of the hand.  Radiology . 1985;  155 785-788
    PubMedSearch in Google Scholar
  • 4 Fornage B D. Achilles tendon: US examination.  Radiology . 1986;  159 759-764
    PubMedSearch in Google Scholar
  • 5 Fornage B D. Ultrasonography of Muscles and Tendons. Examination Technique and Atlas of Normal Anatomy of the Extremities New York: Springer-Verlag 1988
    Search in Google Scholar
  • 6 Weng L, Tirumalai A P, Lowery C M. US extended-field-of-view imaging technology.  Radiology . 1997;  203 877-880
    PubMedSearch in Google Scholar
  • 7 Fornage B D, Atkinson E N, Nock L F, Jones P H. US with extended field of view: phantom-tested accuracy of distance measurements.  Radiology . 2000;  214 579-584
    PubMedSearch in Google Scholar
  • 8 Barberie J E, Wong A D, Cooperberg P L, Carson B W. Extended field-of-view sonography in musculoskeletal disorders.  AJR Am J Roentgenol . 1998;  171 751-757
    PubMedSearch in Google Scholar
  • 9 Fornage B D, Touche D H, Rifkin M D. Small parts real-time sonography: a new ``water-path''.  J Ultrasound Med . 1984;  3 355-357
    PubMedSearch in Google Scholar
  • 10 Fornage B D. Sonography of the extremities [in French].  Paris: Vigot 1991
    Search in Google Scholar
  • 11 Walton J M, Roberts N, Whitehouse G H. Measurement of the quadriceps femoris muscle using magnetic resonance and ultrasound imaging.  Br J Sports Med . 1997;  31 59-64
    PubMedSearch in Google Scholar
  • 12 Emshoff R, Bertram S, Strobl H. Ultrasonographic cross-sectional characteristics of muscles of the head and neck.  Oral Surg Oral Med Oral Path Oral Radiol Endod . 1999;  87 93-106
    PubMedSearch in Google Scholar
  • 13 Hides J A, Richardson C A, Jull G A. Magnetic resonance imaging and ultrasonography of the lumbar multifidus muscle. Comparison of two different modalities.  Spine . 1995;  20 54-58
    PubMedSearch in Google Scholar
  • 14 Rezasoltani A, Malkia E, Vihko V. Neck muscle ultrasonography of male weight-lifters, wrestlers and controls.  Scand J Med Sci Sports . 1999;  9 214-218
    PubMedSearch in Google Scholar
  • 15 Sipila S, Suominen H. Muscle ultrasonography and computed tomography in elderly trained and untrained women.  Muscle Nerve . 1993;  16 294-300
    CrossrefPubMedSearch in Google Scholar
  • 16 Narici M. Human skeletal muscle architecture studied in vivo by non-invasive imaging techniques: functional significance and applications.  J Electromyography Kinesiology . 1999;  9 97-103
    PubMedSearch in Google Scholar
  • 17 Kawakami Y, Abe T, Fukunaga T. Muscle-fiber pennation angles are greater in hypertrophied than in normal muscles.  J Appl Physiol . 1993;  74 2740-2744
    PubMedSearch in Google Scholar
  • 18 Kuno S, Fukunaga T. Measurement of muscle fibre displacement during contraction by real-time ultrasonography in humans.  Eur J Appl Physiol . 1995;  70 45-48
    CrossrefPubMedSearch in Google Scholar
  • 19 Walker F O, Donofrio P D, Harpold G J, Ferrell W G. Sonographic imaging of muscle contraction and fasciculations: a correlation with electromyography.  Muscle Nerve . 1990;  13 33-39
    CrossrefPubMedSearch in Google Scholar
  • 20 Wenzel S, Herrendorf G, Scheel A. Surface EMG and myosonography in the detection of fasciculations: a comparative study.  J Neuroimaging . 1998;  8 148-154
    PubMedSearch in Google Scholar
  • 21 Newman J S, Adler R S, Rubin J M. Power Doppler sonography: use in measuring alterations in muscle blood volume after exercise.  AJR Am J Roentgenol . 1997;  168 1525-1530
    PubMedSearch in Google Scholar
  • 22 Fornage B D, Rifkin M D. Ultrasound examination of tendons.  Radiol Clin North Am . 1988;  26 87-107
    PubMedSearch in Google Scholar
  • 23 Fornage B D, Rifkin M D. Ultrasound examination of the hand and foot.  Radiol Clin North Am . 1988;  26 109-129
    PubMedSearch in Google Scholar
  • 24 Fornage B D. The tendons. In: Rumack CM, Wilson SR, Charboneau JW (eds) Diagnostic Ultrasound, 2nd ed. St. Louis: Mosby-Year Book 1997: 863-883
    Search in Google Scholar
  • 25 Martinoli C, Derchi L E, Pastorino C, Bertolotto M, Silvestri E. Analysis of echotexture of tendons with US.  Radiology . 1993;  186 839-843
    PubMedSearch in Google Scholar
  • 26 Fornage B D. The hypoechoic normal tendon: a pitfall.  J Ultrasound Med . 1987;  6 19-22
    PubMedSearch in Google Scholar
  • 27 Middleton W D, Reinus W R, Totty W G, Melson G L, Murphy W A. US of the biceps tendon apparatus.  Radiology . 1985;  157 211-215
    PubMedSearch in Google Scholar
  • 28 Middleton W D, Reinus W R, Totty W G, Melson G L, Murphy W A. Ultrasonographic evaluation of the rotator cuff and biceps tendon.  J Bone Joint Surg [A] . 1986;  68 440-450
    PubMedSearch in Google Scholar
  • 29 Bianchi S, Zwass A, Abdelwahab I F, Banderali A. Diagnosis of tears of the quadriceps tendon of the knee: value of sonography.  AJR Am J Roentgenol . 1994;  162 1137-1140
    CrossrefPubMedSearch in Google Scholar
  • 30 Blei C L, Nirschl R P, Grant E G. Achilles tendon: US diagnosis of pathologic conditions.  Radiology . 1986;  159 765-767
    PubMedSearch in Google Scholar
  • 31 Mathieson J R, Connell D G, Cooperberg P L, Lloyd-Smith D R. Sonography of the Achilles tendon and adjacent bursae.  AJR Am J Roentgenol . 1988;  151 127-131
    PubMedSearch in Google Scholar
  • 32 Kainberger F M, Engel A, Barton P. Injury of the Achilles tendon: diagnosis with sonography.  AJR Am J Roentgenol . 1990;  155 1031-1036
    PubMedSearch in Google Scholar
  • 33 Takebayashi S, Takasawa H, Banzai Y. Sonographic findings in muscle strain injury: Clinical and MR imaging correlation.  J Ultrasound Med . 1995;  14 899-905
    CrossrefPubMedSearch in Google Scholar
  • 34 Aspelin P, Ekberg O, Thorsson O, Wilhelmsson M, Westlin N. Ultrasound examination of soft tissue injury of the lower limb in athletes.  Am J Sports Med . 1992;  20 601-603
    CrossrefPubMedSearch in Google Scholar
  • 35 Bianchi S, Martinoli C, Abdelwahab I F, Derchi L E, Damiani S. Sonographic evaluation of tears of the gastrocnemius medial head (``tennis leg'').  J Ultrasound Med . 1998;  17 157-162
    PubMedSearch in Google Scholar
  • 36 Fornage B D, Nerot C. Sonographic diagnosis of rhabdomyolysis.  J Clin Ultrasound . 1986;  14 389-392
    PubMedSearch in Google Scholar
  • 37 Lamminen A E, Hekali P E, Tiula E, Suramo I, Korhola O A. Acute rhabdomyolysis: evaluation with magnetic resonance imaging compared with computed tomography and ultrasonography.  Br J Radiol . 1989;  62 326-331
    CrossrefPubMedSearch in Google Scholar
  • 38 Kullmer K, Sievers K W, Rompe J D, Nagele M, Harland U. Sonography and MRI of experimental muscle injuries.  Arch Orthop Trauma Surg . 1997;  116 357-361
    PubMedSearch in Google Scholar
  • 39 Lehto M, Alanen A. Healing of a muscle trauma. Correlation of sonographic and histologic findings in an experimental study in rats.  J Ultrasound Med . 1987;  6 425-429
    PubMedSearch in Google Scholar
  • 40 Bianchi S, Abdelwahab I F, Mazzola C G, Ricci G, Damiani S. Sonographic examination of muscle herniation.  J Ultrasound Med . 1995;  14 357-360
    PubMedSearch in Google Scholar
  • 41 Fornage B D, Schernberg F L. Sonographic diagnosis of foreign bodies of the distal extremities.  AJR Am J Roentgenol . 1986;  147 567-569
    PubMedSearch in Google Scholar
  • 42 Mizel M S, Steinmetz N D, Trepman E. Detection of wooden foreign bodies in muscle tissue: experimental comparison of computed tomography, magnetic resonance imaging, and ultrasonography.  Foot Ankle Int . 1994;  15 437-443
    PubMedSearch in Google Scholar
  • 43 Fornage B D, Schernberg F L. Sonographic preoperative localization of a foreign body in the hand.  J Ultrasound Med . 1987;  6 217-219
    PubMedSearch in Google Scholar
  • 44 Shiels II E W, Babcock D S, Wilson J L, Burch R A. Localization and guided removal of soft-tissue foreign bodies with sonography.  AJR Am J Roentgenol . 1990;  155 1277-1281
    PubMedSearch in Google Scholar
  • 45 Nelson A L, Sinow R M. Real-time ultrasonographically guided removal of nonpalpable and intramuscular Norplant capsules.  Am J Obstet Gynecol . 1998;  178 1185-1193
    PubMedSearch in Google Scholar
  • 46 Peck R J, Metreweli C. Early myositis ossificans: a new echographic sign.  Clin Radiol . 1988;  39 586-588
    CrossrefPubMedSearch in Google Scholar
  • 47 Bodley R, Jamous A, Short D. Ultrasound in the early diagnosis of heterotopic ossification in patients with spinal injuries.  Paraplegia . 1993;  31 500-506
    CrossrefPubMedSearch in Google Scholar
  • 48 Quillin S P, McAlister W H. Rapidly progressive pyomyositis. Diagnosis by repeat sonography.  J Ultrasound Med . 1991;  10 181-184
    PubMedSearch in Google Scholar
  • 49 Rabii R, El Moussaoui A, Rais H. Primary pyogenic abscess of the psoas muscle. Report of 5 cases [in French].  Ann Urol . 1997;  31 361-365
    PubMedSearch in Google Scholar
  • 50 Van Sonnenberg E, Wittich G R, Casola G. Sonography of thigh abscess: detection, diagnosis, and drainage.  AJR Am J Roentgenol . 1987;  149 769-772
    PubMedSearch in Google Scholar
  • 51 Abiri M M, Kirpekar M, Ablow R C. Osteomyelitis: detection with US.  Radiology . 1988;  169 795-797
    PubMedSearch in Google Scholar
  • 52 Saad H, Hamdi A, Gargouri R. Hydatid cyst of the psoas muscle. Report of three cases [in French].  Ann Chir . 1990;  44 299-301
    PubMedSearch in Google Scholar
  • 53 Lamine A, Fikry T, Zryouil B. Primary hydatidosis of the peripheral muscles. 7 case reports [in French].  Acta Orthop Belg . 1993;  59 184-188
    PubMedSearch in Google Scholar
  • 54 Alanen A M, Falck B, Kalimo H, Komu M E, Sonninen V H. Ultrasound, computed tomography and magnetic resonance imaging in myopathies: correlations with electromyography and histopathology.  Acta Neurol Scand . 1994;  89 336-346
    PubMedSearch in Google Scholar
  • 55 Reimers K, Reimers C D, Wagner S, Paetzke I, Pongratz D E. Skeletal muscle sonography: a correlative study of echogenicity and morphology.  J Ultrasound Med . 1993;  12 73-77
    PubMedSearch in Google Scholar
  • 56 Reimers C D, Fleckenstein J L, Witt T N, Müller-Felber W, Pongratz D E. Muscular ultrasound in idiopathic inflammatory myopathies of adults.  J Neurol Sci . 1993;  116 82-92
    CrossrefPubMedSearch in Google Scholar
  • 57 Lindequist S, Larsen C, Daa Schroder H. Ultrasound guided needle biopsy of skeletal muscle in neuromuscular disease.  Acta Radiol . 1990;  31 411-413
    PubMedSearch in Google Scholar
  • 58 Fornage B D. Soft tissue masses: the underutilization of sonography.  Seminars in Musculoskeletal Radiology . 1999;  3 115-133
    PubMedSearch in Google Scholar
  • 59 Sintzoff Jr A S, Gillard I, Van Gansbeke D. Ultrasound evaluation of soft tissue tumors.  J Belge Radiol . 1992;  75 276-280
    PubMedSearch in Google Scholar
  • 60 Fornage B D, Tassin G B. Sonographic appearances of superficial soft-tissue lipomas.  J Clin Ultrasound . 1991;  19 215-220
    CrossrefPubMedSearch in Google Scholar
  • 61 Derchi L E, Balconi G, De Flaviis L, Oliva A, Rosso F. Sonographic appearances of hemangiomas of skeletal muscle.  J Ultrasound Med . 1989;  8 263-267
    PubMedSearch in Google Scholar
  • 62 Fornage B D, Romsdahl M M. Intramuscular myxoma: sonographic appearance and sonographically guided needle biopsy.  J Ultrasound Med . 1994;  13 91-94
    PubMedSearch in Google Scholar
  • 63 Pino G, Conzi G F, Murolo C. Sonographic evaluation of local recurrences of soft tissue sarcomas.  J Ultrasound Med . 1993;  12 23-26
    PubMedSearch in Google Scholar
  • 64 Choi H, Varma D G, Fornage B D, Kim E E, Johnston D A. Soft-tissue sarcoma: MR imaging vs sonography for detection of local recurrence after surgery.  AJR Am J Roentgenol . 1991;  157 353-358
    PubMedSearch in Google Scholar
  • 65 Bruneton J N, Drouillard J, Balu-Maestro C. Imaging of malignant lymphoma of muscular sites [in French].  J Radiol . 1990;  71 185-189
    PubMedSearch in Google Scholar
  • 66 Arkun R, Memis A, Sevinc E, Ustun E E. Sonographic demonstration of skeletal muscle invasion by lymphoma (letter to the editor).  AJR Am J Roentgenol . 1993;  160 1151
    PubMedSearch in Google Scholar
  • 67 Gooding G AW. Tenosynovitis of the wrist. A sonographic demonstration.  J Ultrasound Med . 1988;  7 225-226
    PubMedSearch in Google Scholar
  • 68 Jeffrey Jr B R, Laing F C, Schechter W P, Markison R E, Barton R M. Acute suppurative tenosynovitis of the hand: diagnosis with US.  Radiology . 1987;  162 741-742
    PubMedSearch in Google Scholar
  • 69 Brophy D P, Cunnane G, Fitzgerald O, Gibney R G. Technical report: ultrasound guidance for injection of soft tissue lesions around the heel in chronic inflammatory arthritis.  Clin Radiol . 1995;  50 120-122
    PubMedSearch in Google Scholar
  • 70 Bude R O, Adler R S, Bassett D R, Ikeda D M, Rubin J M. Heterozygous familial hypercholesterolemia: detection of xanthomas in the Achilles tendon with US.  Radiology . 1993;  188 567-571
    PubMedSearch in Google Scholar