AMSSM - American Medical Society for Sports Medicine

AMSSM LIBRARY OF SPORTS ULTRASOUND PATHOLOGY
Objective The Sports Ultrasound Committee looks to create an educational resource directed at residents, fellows, and other learners to review both common and unusual pathology within sports ultrasound using case examples. In exploring the library of sports ultrasound pathology, we intend for learners to gain an appreciation for the nuances of ultrasound imaging and increased confidence in recognition of abnormal findings. Submission Guidelines Current sports medicine fellows are particularly encouraged to submit, with faculty guidance. If a trainee is preparing the submission, the content should be reviewed with a local attending to verify ultrasound image quality and image interpretation accuracy. Following submission, a secondary review will be performed by an AMSSM subcommittee. Edits may be suggested or if images are of low quality, the case may be rejected. Thereafter, the accepted content will be posted and available for member review. All content must be de-identified prior to submission. High quality images and/or videos should be submitted. Low quality images will not be accepted. US Pathology Submission Guidelines – a quick reference guide to a successful submission.



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Rib Fracture 12 year old female soccer athlete presenting for chest wall pain for the past two weeks that was acutely worse two days prior after falling to the ground. Pain exacerbated by deep inspiration and running. Exam shows tenderness to palpation near the anterior 7th rib. Initial radiographs of ribs unremarkable.

Long Head Biceps Subluxation A tennis player with worsening right shoulder pain for 3 months, presented for concern of biceps tendonitis. Speed's test and Yergason's test were positive.

Common Peroneal Nerve Ganglion Cyst A 59-year-old male presents with the complaint of left lower leg pain located at the proximal fibula. The pain started insidiously roughly a year prior and has gradually worsened over that time. The pain radiates down the lateral leg to just above the lateral malleolus. Pain worsened with applied pressure/contact to the proximal fibula and was described as "sharp." The pain has been keeping him from walking or exercising for a period of 2 weeks. Patient rated the pain a 10/10. The patient denied weakness in dorsiflexion of the left foot On examination, there is no weakness of ankle dorsiflexion or great toe extension. Neither restriction of lumbosacral range of motion nor complaints of low back pain was observed. Although tenderness without swelling was present around the left fibular head, Tinel's sign was not evoked along the course of the peroneal nerve. There was no pain, spontaneously or evoked, in association with the passive movement of the knee or ankle. There was no abnormality in sensory examinations. Sciatic root stretch signs were negative.

Fibula Stress Fracture 13-year-old female basketball athlete that presents with insidious onset lower leg pain. Exam with focal tenderness to the distal fibula. Radiographs of the tibia and fibula were unremarkable.

Posterior Cruciate Ligament Tear 16-year-old female softball athlete presents after an acute knee injury during a game. While sliding into a base her cleat got stuck in the dirt and knee twisted. She appreciated immediate swelling. She describes knee instability. On exam an effusion is appreciated with a positive posterior drawer.

Plantar Fascia Partial Rupture 26-year-old female with a three-year history of right plantar heel pain presents with worsening of her symptoms four months after a corticosteroid injection for plantar fasciopathy. Examination is remarkable for tenderness to palpation over the medial plantar heel, specifically over the medial calcaneal tubercle.

De Quervain tenosynovitis A 30-year-old left hand dominant female presents with the complaint of left wrist pain of 3 weeks duration. Pain is located at the base of her thumb and radiates proximally on the radial side of her forearm. Pain is described as sharp and is exacerbated by picking up her newborn baby or with making a fist and is improved with rest. Patient does not identify any injury. There is tenderness to palpation over the first dorsal compartment of the wrist at the level of the radial styloid. Wrist motion is normal. Eichhoff's test was positive.

Core Muscle Injury- Adductor Longus Related Injury A 27 year old male presented with 6 weeks of medial groin pain after barbell back squatting. He felt a pull in his groin at the bottom of the squat with deep hip flexion. Since then, he has had pain with running and cutting as well as with daily activities like urinating, changing positions in bed, and coughing.

Mallet Finger A 34-year-old male presented with 4 days of pain and swelling over the distal aspect of the 4th left digit following an injury during a flag football game. He endorsed the inability to extend his distal interphalangeal joint.

A4 Pulley Rupture 18 YO male presented for left 4th digit finger pain when coming off the wall from rock climbing using crimp grip position. Swelling and tenderness to palpation noted in the distal aspect of the middle phalanx of the left hand

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