Popliteus Partial Tear And Tendinopathy

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Popliteus Partial Tear And Tendinopathy

Authors, Editors, Case Information Author: Carmen Versoza, DO Affiliation: Womack Army Medical Center, Fort Bragg, NC Co Author(s): Bryson Merrill, MD Alex Houser, DO, CAQSM, FAAFP Senior Editor: Wesley Troyer, DO Clinical Vignette: A 43-year-old male professional skydiver presented with left lateral knee pain after a hard landing. Pain was described as a burning sensation that started laterally and radiated towards his patella. Type of Probe Used: 15-4 MHz Linear Transducer #1 - Video View Video Video of the lateral knee with the popliteus tendon in short reveals evidence of neovascularization around the popliteus tendon. #2 - Video View Video Video of the lateral knee with the popliteus tendon in short axis reveals a superficial partial thickness tear of the popliteus tendon. There is also notable cortical irregularity within the sulcus. Unlabeled view of the lateral knee with the popliteus tendon in short axis Unlabeled view of the lateral knee with the popliteus tendon in short axis. Labeled view of the lateral knee with the popliteus tendon in short axis Labeled view of the lateral knee with the popliteus tendon in short axis which reveals a superficial partial thickness tear (curved arrow) of the popliteus tendon (P). There is also notable cortical irregularity within the sulcus (arrow). Iliotibial band (ITB); Gerdy’s tubercle (GT); anterior horn of the lateral meniscus (M); femur (F). Unlabeled view of the lateral knee with the popliteus tendon insertion in long axis Unlabeled view of the lateral knee with the popliteus tendon in long axis. Labeled view of the lateral knee with the popliteus tendon insertion in long axis Labeled view of the lateral knee with the popliteus insertion tendon in long axis which reveals a low grade superficial partial thickness tear (dotted line) of the popliteus tendon (P) in LAX. Iliotibial band (ITB); lateral femoral condyle (LFC). Interpretation 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: Popliteus tendon tears and ruptures are relatively uncommon injuries in isolation and typically result from a traumatic injury mechanism. Pain and physical exam findings can be subtle, non-specific, and limited in diagnostic value. They can also mimic other intra-articular or ligamentous injuries. MRI is a useful imaging modality, but point-of-care ultrasound can be an extremely effective and efficient means of diagnosing isolated popliteus tendon tears or ruptures. Expedited diagnosis can lead to faster and more confident initiation of conservative treatment modalities, which are the mainstay of treatment for isolated popliteus tendon injuries, as surgical management for this condition is controversial and not without risk. Choi, Gyu-Sik MDa; Chang, Min Cheol MDb,*. Partial isolated tear of the popliteus tendon following an in-car traffic accident: A rare cause of knee pain: A CARE-compliant case report. Medicine 102(37):p e35270, September 15, 2023. Koong, D. P., An, V. V. G., Lorentzos, P., Moussa, P., & Sivakumar, B. S. (2018). Non-Operative Rehabilitation of Isolated Popliteus Tendon Rupture in a Rugby Player. Knee surgery & related research, 30(3), 269–272.
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Authors, Editors, Case Information

#1 - Video

#2 - Video

Unlabeled view of the lateral knee with the popliteus tendon in short axis

Labeled view of the lateral knee with the popliteus tendon in short axis

Unlabeled view of the lateral knee with the popliteus tendon insertion in long axis

Labeled view of the lateral knee with the popliteus tendon insertion in long axis

Interpretation

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