MSK/SST

suprapatellar effusion (longitudinal view)

normal

longitudinal, effusion present

decent sized suprapatellar effusion

transverse view of the effusion in the longitudinal view to the left

transverse view of effusion with needle on left side; grab transverse view of effusion just superior to patella and use lateral needle approach

normal

medial meniscus flanked by fluid - left side of the image is the femur, right side is tibia, meniscus extends down from MCL

small effusion outlines the meniscus and makes it more visible here

see a bit of Hoffa's fat pad wedged between patella (screen left) and tibial head (screen right)

Baker's cyst - found on the medial edge of the popliteal space, the neck of the cyst emerges between the medial head of the gastroc and the semimembranosus tendon, forms sort of a speech bubble

tendon's intact but there's a bit of cortical irregularity where it attaches which can be indicative of some chronic rotator cuff tendinopathy

This is a transverse view of the biceps tendon, which is surrounded with fluid. Normally you can see the circular, hyperechoic tendon resting in the bicipital groove. Fluid is indicative of biceps tendinitis or rotator cuff pathology. In this case the patient had a torn subscap and supraspinatus.

not the best look at that subscap but I was just starting to dabble with shoulder US and the Butterfy's not exactly the kind of high res scanning

to see subscap you plop the probe on the biceps tendon in transverse and have the patient externally rotate at the shoulder - pulls the tendon into view

here you see the distal insertion onto the medial tuberosity but anechoic signal medial to that indicative of a space where the tendon used to be

normal biceps tendon - at times it looks like there might be fluid in the sheath but this is just anisotropy

big 'ol collection of fluid overlying the biceps tendon and sheath - this was a patient who had an infraspinatus tear after a fall

same patient as to the left but with shoulder externally rotated to visualize attachment of the subscap, then the patient brings their arm back to a neutral position at which point you can see the biceps tendon again

fluid surrounding the biceps tendon within the sheath

articular subscap tear in patient with persistent shoulder pain after course of physical therapy

infraspinatus tear

patient with turf toe and a small effusion associated with 1st mtp joint

cobblestoning in cellulitis

thenar eminence cellulitis

super localized finger cellulitis with cobblestoning

lil finger bump - lanced it and expressed some pus

large abscess over the lateral distal humerus

cellulitis - looking for a drainable abscess but mostly seeing cobblestoning and disorganized fluid / phlegmon

same patient as on left - power Doppler demonstrating surrounding hyperemia indicative of inflammation

patient with cellulitis after a break in skin happened underwater; looking for retained foreign bodies, just see cobblestoning and a vessel running through

hematoma just over the tibia with a nice lil mirror image artifact; this artifact happens when a large, smooth surface interfaces with tissue of drastically different acoustic impedance, seen most commonly when liver is reflected across the diaphragm into lung area

lipoma in near field (0.2 - 1 cm), could have decreased depth considerably for better image

this was a large soft tissue growth that had increased in size rapidly - felt soft and well circumscribed like a lipoma, patient didn't follow up with formal imaging

• visible between 1 and 3 cm, appearance similar to muscular tissue

appearance was that of a small hemangioma (on visual inspection)

lipoma on anterior hip

the bright, echogenic oval thing is a calcified lump in the patient's scm, possibly from a central line placed during a hospitalization a few weeks prior to my eval

pizza-shaped shard in a patient's foot

ganglion cyst with septation in near field (0.5 to 1.5 cm) visualized via water bath

clinically femoral trochanteric pain syndrome, didn't see a big inflamed bursa with POCUS - gave an injection of kenalog and symptoms resolved

olecranon bursitis - note the anechoic fluid collection superficial to the bright periosteal reflection of the olecranon; coulda decreased the depth quite a bit for a better look