Ultrasound Evaluation of Knee Osteoarthritis.

While radiographs and magnetic resonance imaging (MRI) have long been used in the assessment of osteoarthritis (OA), ultrasound imaging has been rapidly accepted by musculoskeletal providers in both the assessment and treatment of OA. A limiting factor in the use of ultrasound is the proper training required by the user for results to be reliable and reproducible. A standardized ultrasound protocol can potentially address this limiting factor. The critical information to consider in a standardized protocol include proper patient positioning, probe alignment, probe orientation, and identification of the appropriate anatomic landmarks. The outlined protocol considers these factors with the purpose of providing a step-by-step method to assess and monitor knee OA.

Ultrasound Evaluation and Surgical Excision of a Fabella Causing Peroneal Neuropathy in a Track Athlete.

BACKGROUND: There are multiple causes of posterior knee pain and radicular symptoms. A symptomatic fabella is a rare cause but should be considered in the differential diagnosis. PURPOSE: Physicians should consider a symptomatic fabella as a diagnosis when common treatments for posterior knee pain have not alleviated the symptoms. STUDY DESIGN: Case report. METHODS: Review of clinical documentations of an orthopedist, physiatrist, physical therapist, 2 primary care sports medicine physicians, and the surgical report of an orthopedist. RESULTS: It took time and resources including several referrals and imaging modalities to make a final diagnosis. CONCLUSION: Symptomatic fabellae are an uncommon finding but should be considered in the differential diagnosis with an athlete with posterior knee pain. CLINICAL RELEVANCE: Considerable time and resources were used to ultimately diagnose and treat a NCAA Division 1 athlete. Surgical excision was required of a sesamoid bone that is present in 30% of individuals.