Image Interpretation: The popliteus tendon has a small superficial anechoic signal consistent with a partial thickness tear, along with cortical irregularities within the sulcus. Neovascularization was noted on Color Doppler. Normal appearing lateral collateral ligament and iliotibial band, with no evidence of bursitis. Limited evaluation of the anterior horn of the lateral meniscus was unremarkable.
Teaching Pearl: Isolated popliteus tendon tears are uncommon and can be clinically subtle because pain and examination findings may mimic meniscal, intra-articular, or other posterolateral knee pathology. MRI remains useful, but point-of-care ultrasound can also identify focal hypoechoic tendon tearing, tendinopathy, cortical irregularity, and Doppler hyperemia at the point of maximal tenderness.
Early sonographic diagnosis can support timely conservative management for isolated injuries, while also helping determine when additional MRI or orthopedic evaluation might be needed for suspected combined posterolateral corner injury.
References:
1. Wu WT, Onishi K, Mezian K, et al. Ultrasound imaging of the posterior lateral corner of the knee: a pictorial review of anatomy and pathologies. Insights Imaging. 2024;15(1):39. doi:10.1186/s13244-024-01606-x
2. Morrissey CD, Knapik DM. Prevalence, mechanisms, and return to sport after isolated popliteus injuries in athletes: a systematic review. Orthop J Sports Med. 2022;10(2):23259671211073617. doi:10.1177/23259671211073617
3. Russell RL, Katz N, Schroeder AN. Popliteal tendinopathies in the athlete: a narrative review of popliteus, hamstring, and gastrocnemius tendon pathologies at the popliteal fossa. Curr Phys Med Rehabil Rep. 2025;13:33. doi:10.1007/s40141-025-00505-6