Handouts kne oslo feb 2013

Kne
Modul 1 Oslo feb 2013
Frode Garmannvik- Ultralyd Trøndelag
Kne og Ultralyd
Diagnostisk Ultralyd på kne er ikke en foretrukket
billeddiagnostisk metode for full oversikt over
strukturer. Ligamenter, sener, bursa, benoverflater
kan en bra fremstille, men på intraartikulære
strukturer har det begrenset verdi, men en Ul
undersøkelse kan gi oss svar på om intraartikulære
strukturer kan være skadet.
Kne og Ultralyd
The main strength of knee ultrasound is the assessment of para-articular disease. The specific
structures best suited for ultrasound assessment include tendons, muscles and ligaments, as
well as periarticular soft tissue masses. Joint effusions, synovial thickening, bursal fluid
collections, intra-articular loose bodies, ganglion cysts, ligament and tendons tears,
tendonitis and occult fractures can be diagnosed. With experience, ultrasound is a timeefficient, economical imaging tool for assessment of the knee.
Skeletal Radiology
Volume 30, Number 7, 361-377, DOI: 10.1007/s002560100380
L.Friedman, K. Finlay, E. Jurriaans
Anatomi/Sonoanatomi
Skanneprotokoll Kne Grunnkurs
•Anterior
- Distale Quadriceps
- Anteriore leddrecess (suprapatellare)
- Patella (bencortex)
- Patellasene ( Hoffas fettpute, slimposer, tub tibia)
Anatomi/Sonoanatomi
Skanneprotokoll Kne Grunnkurs
• Medialt
- Leddspalt
- MCL
- Meniscus
Anatomi/Sonoanatomi
Skanneprotokoll Kne Grunnkurs
• Lateralt
- Leddspalt
- LCL
- Meniscus
- Tractus iliotibialis
Anatomi/Sonoanatomi
Skanneprotokoll Kne Grunnkurs
• Posterior
- Nerve/karstrukturer
- Gastrocnemius/semtitend,membranosus
- Bakers cyste
Del 1 kne
Anterior
- Quadriceps sene
- Anteriore leddrecess
- Patella
- Patellarsene
Medialt
- MCL
- Mediale menisk
Anatomi/Sonoanatomi
Anterior
1.Quadriceps
2.Patella
3.Patellarsene
4.Hoffas fettpute
5.Tibia
6.Leddvæske
7.Femur
8.Prefemoral fettpute
9.prepatellar fettpute
10.Suprapatellare leddrecess
2.
3.
9.
1.
4.
10.
8.
7.
6.
5.
Anatomi/Sonoanatomi
Medialt
Patologi
Patologieksempler anteriort og medialt
- Væske i anteriore leddrecess
- Part ruptur patellarsene
- Jumpers knee
- Grad 2-3 skade MCL
- Medial meniskruptur ( menisk cyste)
- Atrosetegn
- Brudd patella
- Prepat bursitt
- Påleiringer quadricepsfestet
- Løst legeme
- Ruptur Quadriceps feste patella
- M.Schlatters
!  Effusjon Ant.Leddrecess
Loose body
påleiringer mediale leddspalt
Del 2 kne
Lateralt
- LCL
- Laterale menisk
- Tractus iliotibialis
Posterior
- Mediale gastrocnemiushode
- Kar/nerver
- Distale feste biceps femoris
- Fabella
Anatomi/Sonoanatomi
Lateralt
Anatomi/Sonoanatomi
Lateralt
Anatomi/Sonoanatomi
Posterior
Anatomi/Sonoanatomi
Posterior
Fabella Biceps femoris
Patologi
Patologieksempler lateralt og posterior
- Meniskskade lateralt
- Skade LCL
- Runners kne ( Tractus iliotibialis)
- Lateral cyste
- Bakers cyste
- Rumpert bakers cyste
Patologi
Patologieksempler sjeldne
- A.Poplit Aneurysme
- Sinding Larsen
- Lipom
- Masse i muskel
Referanser
1. Richardson ML, Selby B, Montana MA, Mack LA. Ultrasonography of the knee. Radiol Clin North Am 1988; 26:63-74.
2. Van Holsbeeck M, Intracaso JH. Musculoskeletal ultrasonography. Radiol Clin North Am 1992; 30:907-925.
3. Ptasnik R, Feller J, Bartlett J, Fitt G, Mitchell A, Hennessy O. The value of sonography in the diagnosis of traumatic rupture of
the anterior cruciate ligament of the knee. AJR 1995; 164:1461-1463.
4. Strome GM, Bouffard JA, van Holsbeeck M. Knee. In: Musculoskeletal Ultrasound.Ed Fornage BD. Churchill Livingstone, NY,
1995, 201-219.
5. Bianchi S, Abdelwahab IF, Zwass A et al. Diagnosis of tears of the quadriceps tendon of the knee: value of sonography. Am J
Roentgenol 1994; 162:1137.
6. Jacobson JA, van Holsbeeck MT. Musculoskeletal ultrasonography. Orthop Clin N Amer 1998; 29:135-167.
7. Peck RJ. Ultrasound of the painful hip in children. Br J Radiol 1986: 59:205.
8. Mourad K, King J, Guggiana P. Computed tomography and ultrasound imaging of jumper's knee - patellar tendinitis. Clinical
Radiol 1988;