Best Practice Case Studies-Case 139 Asset 4 Ultrasound Evaluation of Patellar Tendinopathy

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Video Summary

The presentation focused on a 21-year-old collegiate basketball player with chronic anterior knee pain and known proximal patellar tendinopathy. MRI suggested a mid-patellar partial-thickness interstitial delaminating tear, but ultrasound was used for better characterization and a broader anterior knee assessment. The scan showed diffuse patellar tendinopathy with thickening, hypoechogenicity, and neovascularization throughout the tendon. A key finding was a well-defined, elongated anechoic structure within the medial patellar tendon that held its shape under pressure, suggesting an intratendinous cyst rather than a tear. Aspiration later yielded thick gelatinous fluid consistent with a ganglion cyst, confirming the diagnosis.<br /><br />The ultrasound exam also assessed the quadriceps tendon, patella, prepatellar bursa, Hoffa’s fat pad, retinacula, anterior menisci, and trochlear cartilage, all of which were normal. The case highlighted that ultrasound is highly useful for differentiating patellar tendinopathy, interstitial tears, and rare intratendinous cysts. Discussion emphasized the importance of compressibility, circumscribed shape, and lack of vascular flow in identifying cystic lesions, as well as the need to consider associated bone morphology and other inflammatory conditions in the differential.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 139

Topic Knee

Keywords

4th Edition

4th Edition, Case 139

Knee

patellar tendinopathy

intratendinous cyst

ganglion cyst

ultrasound imaging

anterior knee pain

patellar tendon tear

sports medicine