Anatomy

1. Alves TI, Girish G, Kalume Brigido M, Jacobson JA. US of the Knee: Scanning Techniques, Pitfalls, and Pathologic Conditions. Radiographics. 2016 Oct;36(6):1759-1775. doi: 10.1148/rg.2016160019. PMID: 27726755.
2. US of the Knee: Scanning Techniques, Pitfalls, and Pathologic Conditions
3. Timothy I. Alves, Gandikota Girish, Monica Kalume Brigido, and Jon A. Jacobson. RadioGraphics 2016 36:6, 1759-1775
4. Martinoli, C. Musculoskeletal ultrasound: technical guidelines. Insights Imaging 1, 99–141 (2010). https://doi.org/10.1007/s13244-010-0032-9 
5. Cavaignac E, Wytrykowski K, Reina N, et al. Ultrasonographic identification of the anterolateral ligament of the knee. Arthroscopy 2016;32(1):120–126

Scanning Protocol Checklist

Anterior

• Quadriceps muscles and tendon
• Suprapatellar recess
• Patellar tendon
• Pre-patellar bursa and Patella
• Superficial infrapatellar bursa
• Deep infrapatellar bursa
• Vastus medialis and medial retinaculum
• Vastus lateralis and lateral retinaculum
• Distal femoral condyle / trochlea (as indicated)

Medial

• MCL / Tibial collateral ligament
• Valgus stress
• Medial meniscus and joint space
• Pes anserine tendons and bursa
• Medial patellar retinaculum

Lateral

• IT Band
• Lateral meniscus and joint space
• Popliteus tendon
• LCL / Fibular collateral ligament
• Varus stress
• Biceps femoris muscles and tendon
• Lateral patellar retinaculum
• Proximal tib-fib joint (as indicated)

Posterior

• Popliteal fossa
• Popliteal artery and vein
• Semimembranosus muscle and tendon
• Medial and Lateral gastrocnemius muscle and tendon and bursa
• Sciatic, Tibial, and Common fibular nerves
• Posterior horns of both meniscii (as indicated)
• PCL (as indicated)

Relevant AMSSM Videos

Anatomy

• Anterior Knee AMSSM (7 min), Youtube 
• Lateral Knee (9 min)
• Medial Knee (6 min)
• Posterior Knee (11 min)

Pathology

• Sports US Knee Pathology (13 min)

Interventions

• US Guided Interventional Procedures of the Knee (12 min) 

Evidence-based articles relevant to respective joint 

1. US of the knee scanning technique – Radiographics
2. https://pubs.rsna.org/doi/pdf/10.1148/rg.2016160019
3. https://link.springer.com/content/pdf/10.1007/s10067-021-05716-5.pdf
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481034/pdf/13244_2010_Article_32.pdf

Ultrasound-guided procedures for knee

• Knee joint injection
  • Suprapatellar space: short axis in plane, lateral to medial
  • Medial or lateral gutter: short axis out of plane
• Tenotomy
  • Quadriceps tendon
  • Patellar tendon
  • Hamstring tendon
• Bursa injections
  • Superficial and Deep infrapatellar bursa
  • Pes anserine bursa
  • Baker’s cyst (Popliteal cyst)
  • IT band / femoral condyle
  • Voshells bursa
• Other
  • Hoffa’s fat pad hydrodissection
  • Plica injection

Pathology 

1. General
2. Anterior Knee/ Extensor mechanism
   1. Bianchi S, Zwass A, Abdelwahab IF, Banderali A. Diagnosis of tears of the quadriceps tendon of the knee: value of sonography. AJR Am J Roentgenol 1994;162(5):1137–1140
3. US of the Knee: Scanning Techniques, Pitfalls, and Pathologic Conditions
4. Timothy I. Alves, Gandikota Girish, Monica Kalume Brigido, and Jon A. Jacobson. RadioGraphics 2016 36:6, 1759-1775
5. Cushman DM, Ross B, Teramoto M, English J, Joyner JR, Bosley J. Identification of Knee Effusions With Ultrasound: A Comparison of Three Methods. Clin J Sport Med. 2022;32(1):e19-e22. doi:10.1097/JSM.0000000000000823
6. Jiménez Díaz F, Gitto S, Sconfienza LM, Draghi F. Ultrasound of iliotibial band syndrome. J Ultrasound. 2020;23(3):379-385. doi:10.1007/s40477-020-00478-3
7. Lee JI, Song IS, Jung YB, et al. Medial collateral ligament injuries of the knee: ultrasonographic findings. J Ultrasound Med 1996;15(9):621–625
8. Smith J, Sayeed YA, Finnoff JT, Levy BA, Martinoli C. The bifurcating distal biceps femoris tendon: potential pitfall in musculoskeletal sonography. J Ultrasound Med 2011;30(8):1162–1166
9. Foley R, Fessell D, Yablon C, Nadig J, Brandon C, Jacobson J. Sonography of traumatic quadriceps tendon tears with surgical correlation. J Ultrasound Med 2015;34(5):805–810.
10. Wakefield RJ, Balint PV, Szkudlarek M, et al. Musculoskeletal ultrasound including definitions for ultrasonographic pathology. J Rheumatol 2005;32(12):2485–2487. 
11. Bonnefoy O, Diris B, Moinard M, Aunoble S, Diard F, Hauger O. Acute knee trauma: role of ultrasound. Eur Radiol 2006;16(11):2542–2548.
12. Khan KM, Bonar F, Desmond PM, et al. Patellar tendinosis (jumper’s knee): findings at histopathologic examination, US, and MR imaging—Victorian Institute of Sport Tendon Study Group. Radiology 1996;200(3):821–827.
13. Azzoni R, Cabitza P. Is there a role for sonography in the diagnosis of tears of the knee menisci? J Clin Ultrasound 2002;30(8):472–476.
14. Wareluk P, Szopinski KT. Value of modern sonography in the assessment of meniscal lesions. Eur J Radiol 2012;81(9):2366–2369. 
15. Goh LA, Chhem RK, Wang SC, Chee T. Iliotibial band thickness: sonographic measurements in asymptomatic volunteers. J Clin Ultrasound 2003;31(5):239–244.
16. Miller TT. Sonography of injury of the posterior cruciate ligament of the knee. Skeletal Radiol 2002;31(3):149–154.
17. Skovgaard Larsen LP, Rasmussen OS. Diagnosis of acute rupture of the anterior cruciate ligament of the knee by sonography. Eur J Ultrasound 2000;12(2):163–167.

Recommended books/websites for reference: 

-Fundamentals of Musculoskeletal Ultrasound by Jon A. Jacobson 

-Atlas of Ultrasound-Guided Musculoskeletal Injections by Gerard Malanga and Kenneth Mautner 

-Ultrasound of the Musculoskeletal System: Anatomical exploration and pathology by Inigo Iriate, Carles Pedret, Ramon Balius, Luis Cerezal 

-Ultrasound of the Musculoskeletal System by S. Bianchi and C. Martinoli 

-UltrasoundGuidance.com

https://www.nysora.com/ultrasound-of-the-musculoskeletal-system/

https://mskultrasound.net

https://radiopaedia.org/articles/musculoskeletal-ultrasound?lang=us