KEY FACTS
Terminology
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Ligament: Fibrous band that connects 2 bones and helps stabilize intervening joint
Imaging
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Ligament tears can be partial or complete and have same appearance irrespective of ligament location
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Acute stage
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Diffuse or localized ligament swelling
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Ligament fiber discontinuity with hypoechoic gap at site of tear
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Surrounding soft tissue subcutaneous edema, hemorrhage, and hyperemia
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Chronic stage: 4 possible sequelae of ligament tear exist
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Diffusely thickened, continuous ligament
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Diffusely thickened, discontinuous ligament
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Diffusely attenuated ligament
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Absent ligament
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Clinical Issues
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Most frequent musculoskeletal injury
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Leads to instability, impingement, dystrophic calcification, or contracture
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Often associated with other osseous or ligamentous injuries
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Healed ligament tissue post injury remains inferior to normal ligament
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Prior injury can confound clinical and imaging assessment
Scanning Tips
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Align transducer along long axis of ligament
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Adjust transducer alignment to minimize anisotropy
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Surrounding edema/fluid and hyperemia on color Doppler are clues to which ligament(s) could be injured
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Dynamically stretch ligament to maximize visibility of tear and determine joint laxity
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Examine contralateral, noninjured side for comparison
