Sartorius Tendon Injury

About sartorius tendon injuries in adolescents.

14 years-old male soccer player presents with right hip pain after kicking. The site of referred higher pain is located on the anterior-superior iliac spine.

The dynamic ultrasound exam shows a partial strain of the sartorius tendon bone attachment, togheter with a gross irregularity of the cortical bone surface, a common finding in young patients; power-doppler evaluation defines the typical post-traumatic hypervascularity.

In these cases I always suggest to perform also the Mri exam for the correct diagnosis and clinical management.

Ultrasound imaging is not enough: what’s about the osteochondral involvment?

antero-superior-iliac-spine

Axial (left) and Sagittal Pdw-Spair Mri scans (1.5 Tesla).

The partial tear of sartorius tendon with associated marrow and soft tissue edema is evident. Apophyseal injuries to the hip and pelvis are quite frequent in skeletally immature individuals playing football. Combining ultrasound and Mri imaging modalities is the gold standard, especially beacuse radiographs may be interpreted as negative also in case of non-displaced fractures.

If you are a “pure sonographer” or a physiotherapist don’t forget to talk with a radiologist about these kind of injuries.

Plantar Fascitis

About dynamic ultrasound study of chronic plantar fascitis.

In a previous post I wrote about the examination of the plantar aponeurosis;

repetitive traumas produce microtears of some fibers of the plantar aponeurosis, not only close to the site of its attachment but also distally, due to the own foot biomechanics of the patients.

Today I show you the case of a chronic partial rupture of plantar aponeurosis in 20-year-old male soccer player.

chronic-plantar-fascitis

Ge Stir (left) and Coronal T2w (right) Mri sequences (0.3 Tesla).

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Axial T2w (left) and Coronal Fast Stir (right) Mri scans of the same patient (0.3 Tesla).

As usually I also perform the dynamic ultrasound exam, togheter with elastosonosgraphy evaluation.

The elastosonography examination better depicts the presence of a granulation tissue (green colour) as happened after a partial tear inside the fibrous scar of a chronic plantar fascitis.