Thanks to Niek Vink,Physiotherapist and Ultrasonographer, for contributing this case from his clinic at the Dutch National Training Centre for Ultrasound. It provides an insight into the appearance of tissues with acute trauma.
This interesting case gives insight into the sonographic appearance of an acute patella tendon impact injury and the visible changes still present 4 1/2 months after the injury. This patient was in his early 30's and sustained direct trauma from a hockeyball impacting against the distal patella tendon. The patient presented with direct tenderness over the patella tendon.
Ultrasound images at five weeks (Figure 1 and 2) post trauma show a superficial hypo-echoic area in the medial-distal part of the patellar tendon. Focal areas with loss of collagen continuity.
Ultrasound images at 4 1/2 months post trauma show an increasing reflectivity of the tendon and a return of the collagen bundle patterns in the longitudinal scan. Doppler imaging shows still one active vessel in the lesion. There is a complete return to sports at this stage.
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