Ultrasound: Tendons


  • U/S can be used to assess continuity of tendons and ligaments
  • They have a property called anisotropy which means they have 2 different appearances if assess longitudinally or transversely





  1. Use linear probe (high frequency probe)
  2. Place probe in longitudinal plane over suspect tendon; high yield locations inlcude:
    • Biceps can be proximal or distal
    • Patella tendons 2cm from insertion on patella
    • Achilles 2-6cm above calcaneus
  3. Fan and slide side to side to optimize your view
  4. Slide distal to proximal to find defect
  5. Turn probe 90° to assess for tendon body defects


  • Positive Findings
    • Discontinuity in longitudinal view of ligament
    • Collection of fluid in longitudinal or transverse view suggests injury
  • Negative Findings
    • Longitudinal views show continuous densely striped parallel lines
    • Transverse views show oval structure with punctate interior

Pearls and Pitfalls

  • Look at other limb for "normal" anatomy
  • Have patient range limb and view in real time
  • Know your limitations if case is not clear cut
  • Do not mistake anisotropy for tendon rupture

See Also

External Links