What Is the Difference Between the Appearance of Tendinosis and Tendon Tears on Ultrasound?

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What Is the Difference Between the Appearance of Tendinosis and Tendon Tears on Ultrasound?

By Learn MSK Sono FEATURING Jamie Bie, RMSKS, RVT, RDMS

219 views

May 29, 2023

What characteristics help distinguish the appearance of tendinosis from a tendon tear on ultrasound?

A ...
read more ↘ normal tendon appears as a firmly packed echogenic structure with a uniform, fibrillar pattern.

Features of tendinosis:
- Hypoechoic thickening of the tendon
- Heterogeneous echotexture
- Loss of fibrillar pattern without disruption of fibers
- Indistinct margins
- Intrasubstance cystic degeneration
- Hyperemia with power doppler from neovascularization

Findings may be focal or diffuse!

Features of tendon tearing:
- Discrete defect seen in tendon substance
- Sharp margins of defect
- Typically anechoic gap, but may have mixed echogenicity due to hemorrhage or debris
- No vascularity will be present within defect, even if internal echoes are present
- Tears may be partial thickness or full thickness

Small partial tears can be difficult to differentiate from tendinosis, but treatment is conservative for both findings.
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