الفهرس 
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Abstract
Pain and other disorders of the knee are a common presenting complaint in the ambulatory setting, knee. The benefits of US include portability, low cost, high spatial resolution, dynamic imaging, and ability to guide percutaneous interventions when indicated. US also allows direct patient contact, facilitating immediate clinical correlation and the ability to compare with the contralateral knee. The knee joint is divided into anterior, medial, lateral, and posterior compartments for structured evaluation of the tendons, ligaments, joint space, osseous structures, as well as peripheral nerves and vasculature.
US is particularly well suited for evaluating injuries of the quadriceps and patellar tendons, joint effusions, and fluid collections around the knee. There is additional utility in evaluation of the distal hamstrings tendons, tract, the superficial patellar cortex, the common peroneal nerve, the popliteal the iliotibial vessels, and juxta-articular cystic collections including Baker cyst. In-depth appreciation of relevant sonographic anatomy, common pathologic conditions, knowledge of important pitfalls, and mastery of US technique will allow one to effectively use this powerful bedside tool for the evaluation of a wide variety of knee disorders. Acute knee trauma: role of ultrasound.
Our study aimed to evaluate the ability of US to describe normal anatomy of the Knee, to describe the US techniques for comprehensive evaluation of the knee and to recognize the US appearance of common pathologic conditions, as well as common pitfalls/ mimics of disease.
This study was carried out on 30 patients with acute knee pain (less than three months duration). This study was carried in the outpatient orthopedic clinic, Ain Shams University hospitals to the ultrasonographic Imaging section of the department of Radiology, Ain Shams University Hospitals.
The main results of this study were as follows:
Regarding the demographic characteristics in the studied patients, it was found that the age of patients ranged from 18 to 70 years with mean ±SD was 42.75± 13.1 years and median was 43.5 years. 18 (60%) patients were males and 12 (40%) of them were females with male to female ratio was 1.5:1.
Regarding meniscal degeneration among the studied group, we found that the posterior horn is one of the most common areas for degenerative meniscus. Posterior horn medial meniscus degeneration was found in more than half (53.3%) cases while bone tenderness was found in 43 (95.6%) cases while the. Posterior horn lateral meniscus degeneration was found in eight (26.7%) cases.
Also, regarding meniscal tear among the studied groups, we found that four cases (13.3%) had posterior horn medial meniscus tear while eight cases (26.7%) had posterior horn lateral meniscus tear. It was observed that degeneration in posterior horn was higher than posterior horn in both medial and lateral menisci.
Regarding osteoarthritic changes among the studied cohort, we found that 12 cases (40%) showed osteoarthritic changes while these changed were not found in 18 cases (60%).
Traditionally, Osteoarthritis has been defined as degenerative changes in bone, cartilage, and the soft tissues of the joints.
In the current study, none of patients had Anterior Cruciate Ligament (ACL) tear.
Regarding the distribution of the studied patients regarding joint effusion & synovial effusion, it was fond that most cases (86.7%) had effusion. More than half cases (53.3%) had minimal effusion, seven of them (23.3%) showed mild effusion and three cases (10%) had moderate effusion.
Regarding the distribution of the studied patients regarding pre and infra patellar Bursitis, it was found that there were three cases (10%) had pre and infra patellar bursitis.
It was observed that half cases (50%) had other lesions. Three cases had backer cyst their measurements were 7x3.5 mm, 80x46 mm and 15x9 mm respectively. other one had patient with history of Fanconi anemia and effusion showing turbidity suspecting hematoarthrosis. In another case, patient with history of hemophilia and effusion showing turbidity suspecting hematoartherosis
There was one patients had quadriceps tendon showing few foci of calcification at its superficial part.no tendon tear, patellar tendon shows diffuse thickening and reduced echopattern denoting tendinosis, prepatellar subcutaneous edema.
There was one case had subcutaneous edema with small localized collection measuring 14x6.5mm below site of amputation another collection overlying distal part of femur measuring 31 x5 mm suggesting postoperative inflammatory process. While another 3cases had semimembranosus tenosynovitis and synovial thickening.
Intramuscular hematoma between gasteroconemus and solus suggesting solus edema with no tear or interruption (grade 1 tear). One case had patellar tendon partial thickness tear. One case had cleavage type injury to the subcutaneous fart in suprapatellar region. Finally, one case had well defined mixed echogenicity mainly hypoechoic subcutaneous soft tissue lesion at the back of the knee measures 25x10 mm with its inferior border shows hypoechoic area with partial loss of definition and central cystic changes reaching up to the skin suggesting subcutaneous lipoma with inflammatory changes surrounding its lower part.
Ultrasonography is a useful screening tool for the initial diagnosis of knee pathology. The main US findings were joint effusion, posterior horn medial meniscus tear, posterior horn lateral meniscus tear, anserinus bursitis, osteoarthritic changes, popliteal cysts and patellar tendinitis.
Further studies with larger sample size and longer follow-up are needed to confirm our results and to evaluate the diagnostic accuracy of US in knee pathology.