Ligament: Fibrous band that connects 2 bones and helps stabilize intervening joint

Ligament tears can be partial or complete and have same appearance irrespective of ligament location

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

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

Most frequent musculoskeletal injury

Leads to instability, impingement, dystrophic calcification, or contracture

Often associated with other osseous or ligamentous injuries

Healed ligament tissue post injury remains inferior to normal ligament

Prior injury can confound clinical and imaging assessment

Align transducer along long axis of ligament

Adjust transducer alignment to minimize anisotropy

Surrounding edema/fluid and hyperemia on color Doppler are clues to which ligament(s) could be injured

Dynamically stretch ligament to maximize visibility of tear and determine joint laxity

Examine contralateral, noninjured side for comparison