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

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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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