<p begin="00:00:07.634" end="00:00:09.403" style="s2">- [Voiceover] A linear<br />array transducer with a</p>
<p begin="00:00:09.403" end="00:00:12.522" style="s2">musculoskeletal exam type<br />is used to perform an</p>
<p begin="00:00:12.522" end="00:00:16.027" style="s2">ultrasound examination<br />of the cubital tunnel.</p>
<p begin="00:00:16.027" end="00:00:18.815" style="s2">The patient's elbow is<br />placed in forceful internal</p>
<p begin="00:00:18.815" end="00:00:22.249" style="s2">rotation, with the<br />elbow in full extension.</p>
<p begin="00:00:22.249" end="00:00:25.700" style="s2">The transducer is placed over<br />the posterior medial elbow</p>
<p begin="00:00:25.700" end="00:00:28.441" style="s2">in a transverse fashion,<br />with the orientation marker</p>
<p begin="00:00:28.441" end="00:00:31.262" style="s2">directed towards the patient's right.</p>
<p begin="00:00:31.262" end="00:00:33.481" style="s2">The medial epicondyle of the elbow,</p>
<p begin="00:00:33.481" end="00:00:34.963" style="s2">and the olecranon process,</p>
<p begin="00:00:34.963" end="00:00:37.949" style="s2">are seen in the epicondylar<br />groove as bright,</p>
<p begin="00:00:37.949" end="00:00:40.115" style="s2">hyperechoic structures.</p>
<p begin="00:00:40.115" end="00:00:43.320" style="s2">The ulnar nerve can be<br />seen as a hypoechoic,</p>
<p begin="00:00:43.320" end="00:00:46.500" style="s2">vesiculated structure near<br />the medial epicondyle.</p>
<p begin="00:00:46.500" end="00:00:49.535" style="s2">The triceps tendon appears<br />as a hyperechoic area,</p>
<p begin="00:00:49.535" end="00:00:52.508" style="s2">overlying the olecranon process.</p>
<p begin="00:00:52.508" end="00:00:54.914" style="s2">The transducer should<br />be slowly moved distally</p>
<p begin="00:00:54.914" end="00:00:57.282" style="s2">to evaluate the cubital tunnel.</p>
<p begin="00:00:57.282" end="00:01:00.799" style="s2">The cubital tunnel retinaculum<br />appears as a hyperechoic</p>
<p begin="00:01:00.799" end="00:01:03.508" style="s2">line above the deeper structures.</p>
<p begin="00:01:03.508" end="00:01:06.617" style="s2">The ulnar head of the<br />flexor carpi ulnaris muscle</p>
<p begin="00:01:06.617" end="00:01:08.813" style="s2">can be seen as a hypoechoic structure</p>
<p begin="00:01:08.813" end="00:01:11.094" style="s2">near the olecranon process.</p>
<p begin="00:01:11.094" end="00:01:13.901" style="s2">The humoral head of the<br />flexor carpi ulnaris muscle</p>
<p begin="00:01:13.901" end="00:01:17.350" style="s2">appears similarly on the<br />medial side of the image.</p>
<p begin="00:01:17.350" end="00:01:20.103" style="s2">The ulnar nerve can be<br />seen as a hypoechoic,</p>
<p begin="00:01:20.103" end="00:01:23.603" style="s2">rounded structure between the two muscles.</p>

<p begin="00:00:07.662" end="00:00:09.398" style="s2">- [Voiceover] A linear array transducer</p>
<p begin="00:00:09.398" end="00:00:11.879" style="s2">with a musculoskeletal exam type is used</p>
<p begin="00:00:11.879" end="00:00:15.670" style="s2">to perform an ultrasound<br />examination of the ulnar nerve.</p>
<p begin="00:00:15.670" end="00:00:18.249" style="s2">The patient is asked to<br />flex their elbow slightly</p>
<p begin="00:00:18.249" end="00:00:20.584" style="s2">with the hand placed on<br />the examination table</p>
<p begin="00:00:20.584" end="00:00:24.030" style="s2">and the forearm in<br />forced internal rotation.</p>
<p begin="00:00:24.030" end="00:00:27.231" style="s2">The transducer is placed<br />over the distal posterior arm</p>
<p begin="00:00:27.231" end="00:00:28.765" style="s2">in a transverse fashion,</p>
<p begin="00:00:28.765" end="00:00:30.732" style="s2">with the orientation<br />marker directed toward</p>
<p begin="00:00:30.732" end="00:00:32.380" style="s2">the patient's right side</p>
<p begin="00:00:32.380" end="00:00:35.145" style="s2">and the elecranon on facing the examiner.</p>
<p begin="00:00:35.145" end="00:00:37.952" style="s2">The ulnar nerve can be seen a hypoechoic</p>
<p begin="00:00:37.952" end="00:00:39.544" style="s2">oval structure.</p>
<p begin="00:00:39.544" end="00:00:41.742" style="s2">The medial epichondial of the humerus</p>
<p begin="00:00:41.742" end="00:00:44.923" style="s2">and the elecranon process<br />can be seen as curved</p>
<p begin="00:00:44.923" end="00:00:47.655" style="s2">bright hypoechoic surfaces that form</p>
<p begin="00:00:47.655" end="00:00:49.253" style="s2">the epoicondrial groove.</p>
<p begin="00:00:49.253" end="00:00:51.908" style="s2">The triceps tendon is seen as a hypoechoic</p>
<p begin="00:00:51.908" end="00:00:53.581" style="s2">speckled structure.</p>
<p begin="00:00:53.581" end="00:00:55.742" style="s2">tTe transducer is slowly translated</p>
<p begin="00:00:55.742" end="00:00:57.587" style="s2">down the cubital tunnel.</p>
<p begin="00:00:57.587" end="00:00:59.786" style="s2">The ulnar head and the humeral head</p>
<p begin="00:00:59.786" end="00:01:02.020" style="s2">of the flexal carbial muscle</p>
<p begin="00:01:02.020" end="00:01:05.458" style="s2">can be seen as oval, hypoechoic structures</p>
<p begin="00:01:05.458" end="00:01:07.093" style="s2">surrounding the ulnar nerve.</p>
<p begin="00:01:07.093" end="00:01:09.605" style="s2">The cubital tunnel retanaculum can be seen</p>
<p begin="00:01:09.605" end="00:01:11.921" style="s2">as a hypoechoic band-like structure</p>
<p begin="00:01:11.921" end="00:01:14.171" style="s2">that overlies the muscles.</p>

<p begin="00:00:07.299" end="00:00:08.884" style="s2">- [Voiceover] A linear array transducer</p>
<p begin="00:00:08.884" end="00:00:11.445" style="s2">with a musculoskeletal exam type is used</p>
<p begin="00:00:11.445" end="00:00:15.224" style="s2">to perform and ultrasound<br />examination of the olecranon.</p>
<p begin="00:00:15.224" end="00:00:18.477" style="s2">The patient is asked to<br />flex their elbow 90 degrees</p>
<p begin="00:00:18.477" end="00:00:21.409" style="s2">with the hand placed on<br />the examination table.</p>
<p begin="00:00:21.409" end="00:00:24.451" style="s2">The transducer is placed<br />over the posterior elbow</p>
<p begin="00:00:24.451" end="00:00:27.501" style="s2">in a longitudinal fashion<br />with the orientation marker</p>
<p begin="00:00:27.501" end="00:00:30.104" style="s2">directed toward the patient's head.</p>
<p begin="00:00:30.104" end="00:00:32.221" style="s2">The distal triceps muscle appears</p>
<p begin="00:00:32.221" end="00:00:34.988" style="s2">as a hypoechoic striated structure,</p>
<p begin="00:00:34.988" end="00:00:38.403" style="s2">which transitions to the<br />fibular triceps tendon.</p>
<p begin="00:00:38.403" end="00:00:40.558" style="s2">The olecranon is seen as a bright,</p>
<p begin="00:00:40.558" end="00:00:43.159" style="s2">hyperechoic curved structure.</p>
<p begin="00:00:43.159" end="00:00:46.296" style="s2">The posterior fat pad<br />can be seen as a complex</p>
<p begin="00:00:46.296" end="00:00:51.170" style="s2">hyperechoic area overlying the<br />posterior olecranon recess.</p>
<p begin="00:00:51.170" end="00:00:54.787" style="s2">The transducer is rotated<br />90 degrees counterclockwise</p>
<p begin="00:00:54.787" end="00:00:56.538" style="s2">with the orientation marker directed</p>
<p begin="00:00:56.538" end="00:00:58.738" style="s2">toward the patient's right side.</p>
<p begin="00:00:58.738" end="00:01:02.604" style="s2">The triceps tendon appears as<br />a hyperechoic oval structure</p>
<p begin="00:01:02.604" end="00:01:06.224" style="s2">overlying the hyperechoic<br />surface of the olecranon.</p>
<p begin="00:01:06.224" end="00:01:09.558" style="s2">Gentle backward and forward<br />rocking of the patient's elbow</p>
<p begin="00:01:09.558" end="00:01:12.122" style="s2">may be helpful to shift elbow joint fluid</p>
<p begin="00:01:12.122" end="00:01:15.872" style="s2">into the olecranon<br />recess for visualization.</p>

<p begin="00:00:07.460" end="00:00:09.135" style="s2">- [Voiceover] A linear array transducer</p>
<p begin="00:00:09.135" end="00:00:11.309" style="s2">with a musculoskeletal exam type</p>
<p begin="00:00:11.309" end="00:00:13.848" style="s2">is used to perform an<br />ultrasound examination</p>
<p begin="00:00:13.848" end="00:00:15.776" style="s2">of the medial elbow.</p>
<p begin="00:00:15.776" end="00:00:18.227" style="s2">The patient is placed in a supine position</p>
<p begin="00:00:18.227" end="00:00:19.982" style="s2">with the elbow slightly flexed,</p>
<p begin="00:00:19.982" end="00:00:22.782" style="s2">and the forearm forcefully<br />externally rotated</p>
<p begin="00:00:22.782" end="00:00:25.412" style="s2">and resting on the examination table.</p>
<p begin="00:00:25.412" end="00:00:28.394" style="s2">The transducer is placed<br />over the medial epicondyle</p>
<p begin="00:00:28.394" end="00:00:31.456" style="s2">in a longitudinal fashion,<br />with the orientation marker</p>
<p begin="00:00:31.456" end="00:00:34.130" style="s2">directed towards the patient's head.</p>
<p begin="00:00:34.130" end="00:00:35.756" style="s2">The flexor tendon can be seen</p>
<p begin="00:00:35.756" end="00:00:38.481" style="s2">as a fibrillar patterned structure.</p>
<p begin="00:00:38.481" end="00:00:40.264" style="s2">The medial epicondyle is seen as</p>
<p begin="00:00:40.264" end="00:00:42.946" style="s2">a bright, hyperechoic, curved structure</p>
<p begin="00:00:42.946" end="00:00:45.026" style="s2">lying below the tendon.</p>
<p begin="00:00:45.026" end="00:00:48.006" style="s2">The anterior bundle of the<br />medial collateral ligament</p>
<p begin="00:00:48.006" end="00:00:50.840" style="s2">can be seen as a thin, hyperechoic band</p>
<p begin="00:00:50.840" end="00:00:54.562" style="s2">that runs between the medial<br />epicondyle and the ulna.</p>
<p begin="00:00:54.562" end="00:00:56.968" style="s2">Dynamic scanning with valgus stress</p>
<p begin="00:00:56.968" end="00:00:59.964" style="s2">can be used to evaluate the<br />medial collateral ligament</p>
<p begin="00:00:59.964" end="00:01:01.881" style="s2">for laxity or injuries.</p>

<p begin="00:00:07.374" end="00:00:09.089" style="s2">- [Voiceover] A linear array transducer</p>
<p begin="00:00:09.089" end="00:00:12.017" style="s2">with a musculoskeletal exam<br />type is used to perform</p>
<p begin="00:00:12.017" end="00:00:14.388" style="s2">an ultrasound examination of the Lateral</p>
<p begin="00:00:14.388" end="00:00:16.672" style="s2">Collateral Ligament of the Knee.</p>
<p begin="00:00:16.672" end="00:00:18.568" style="s2">The patient is in a supine position</p>
<p begin="00:00:18.568" end="00:00:21.341" style="s2">with the knee flexed 90 degrees.</p>
<p begin="00:00:21.341" end="00:00:23.742" style="s2">The transducer is placed longitudinally</p>
<p begin="00:00:23.742" end="00:00:25.916" style="s2">over the outer knee at the joint space</p>
<p begin="00:00:25.916" end="00:00:27.753" style="s2">with the orientation marker directed</p>
<p begin="00:00:27.753" end="00:00:29.563" style="s2">to the patient's head.</p>
<p begin="00:00:29.563" end="00:00:32.682" style="s2">The fibular head is a<br />bright, hyperechoic structure</p>
<p begin="00:00:32.682" end="00:00:35.641" style="s2">where the biceps femoris muscle attaches.</p>
<p begin="00:00:35.641" end="00:00:37.553" style="s2">The transducer should be translated</p>
<p begin="00:00:37.553" end="00:00:39.726" style="s2">in a windshield wiper type maneuver</p>
<p begin="00:00:39.726" end="00:00:42.375" style="s2">to connect the fibula<br />and the femoral condyle</p>
<p begin="00:00:42.375" end="00:00:45.671" style="s2">to identify the Lateral<br />Collateral Ligament.</p>
<p begin="00:00:45.671" end="00:00:47.588" style="s2">The ligament can be seen as a packed,</p>
<p begin="00:00:47.588" end="00:00:50.143" style="s2">fibular patterned, tight,<br />elliptical structure</p>
<p begin="00:00:50.143" end="00:00:52.167" style="s2">arising from the lateral condyle,</p>
<p begin="00:00:52.167" end="00:00:54.630" style="s2">and inserting on the fibular head.</p>
<p begin="00:00:54.630" end="00:00:57.277" style="s2">The transducer is then rotated 90 degrees</p>
<p begin="00:00:57.277" end="00:01:00.799" style="s2">counterclockwise to<br />obtain a short-axis view.</p>
<p begin="00:01:00.799" end="00:01:02.914" style="s2">The Lateral Collateral Ligament appears</p>
<p begin="00:01:02.914" end="00:01:05.520" style="s2">as a sheet-like structure,<br />which should be scanned</p>
<p begin="00:01:05.520" end="00:01:07.742" style="s2">from its proximal to distal insertion</p>
<p begin="00:01:07.742" end="00:01:10.159" style="s2">to complete the examination.</p>

<p begin="00:00:07.332" end="00:00:09.322" style="s2">- [Voiceover] A linear<br />array transducer with</p>
<p begin="00:00:09.322" end="00:00:11.270" style="s2">a musculoskeletal exam type,</p>
<p begin="00:00:11.270" end="00:00:13.585" style="s2">is used to perform an<br />ultrasound examination</p>
<p begin="00:00:13.585" end="00:00:16.264" style="s2">of the anterior recess of the elbow.</p>
<p begin="00:00:16.264" end="00:00:18.416" style="s2">The patient is placed<br />in a supine position,</p>
<p begin="00:00:18.416" end="00:00:21.463" style="s2">with the elbow extended<br />over the examination table,</p>
<p begin="00:00:21.463" end="00:00:25.302" style="s2">a pillow under the elbow,<br />and the forearm supinated.</p>
<p begin="00:00:25.302" end="00:00:27.760" style="s2">The transducer is placed<br />over the distal humerus</p>
<p begin="00:00:27.760" end="00:00:30.524" style="s2">in a transverse fashion,<br />with the orientation marker</p>
<p begin="00:00:30.524" end="00:00:33.079" style="s2">directed toward the patient's right side.</p>
<p begin="00:00:33.079" end="00:00:35.316" style="s2">The brachialis tendon is seen as</p>
<p begin="00:00:35.316" end="00:00:37.389" style="s2">a hypoechoic fibrillar structure</p>
<p begin="00:00:37.389" end="00:00:40.639" style="s2">extending over the bright<br />hyperechoic curved surface</p>
<p begin="00:00:40.639" end="00:00:42.267" style="s2">of the distal humerus.</p>
<p begin="00:00:42.267" end="00:00:44.178" style="s2">The articular cartilage of the humerus</p>
<p begin="00:00:44.178" end="00:00:46.741" style="s2">can be seen as a thin hypoechoic line</p>
<p begin="00:00:46.741" end="00:00:49.383" style="s2">that extends over the humeral surface.</p>
<p begin="00:00:49.383" end="00:00:51.166" style="s2">The corrinoid fossa is seen as</p>
<p begin="00:00:51.166" end="00:00:54.339" style="s2">a concavity of the anterior<br />surface of the humerus.</p>
<p begin="00:00:54.339" end="00:00:57.260" style="s2">The anterior fat pad<br />fills the corrinoid fossa</p>
<p begin="00:00:57.260" end="00:01:00.066" style="s2">and appears as a hypoechoic structure.</p>
<p begin="00:01:00.066" end="00:01:03.921" style="s2">The transducer is rotated<br />90 degrees counter-clockwise</p>
<p begin="00:01:03.921" end="00:01:05.303" style="s2">with the orientation marker</p>
<p begin="00:01:05.303" end="00:01:07.823" style="s2">directed toward a 9 o'clock position.</p>
<p begin="00:01:07.823" end="00:01:09.569" style="s2">The brachialis muscle is seen as</p>
<p begin="00:01:09.569" end="00:01:11.900" style="s2">a hypoechoic striated structure</p>
<p begin="00:01:11.900" end="00:01:15.272" style="s2">encompassing the hyperechoic<br />brachialis tendon.</p>
<p begin="00:01:15.272" end="00:01:18.203" style="s2">The anterior distal humeral epiphysis</p>
<p begin="00:01:18.203" end="00:01:20.972" style="s2">appears as a bright hyperechoic wavy line</p>
<p begin="00:01:20.972" end="00:01:24.054" style="s2">with a thin overlying articular cartilage.</p>
<p begin="00:01:24.054" end="00:01:26.327" style="s2">The humeral capitellum is seen as</p>
<p begin="00:01:26.327" end="00:01:28.320" style="s2">a rounded structure laterally,</p>
<p begin="00:01:28.320" end="00:01:30.429" style="s2">and the humeral trochlea appears as</p>
<p begin="00:01:30.429" end="00:01:32.929" style="s2">a V-shaped structure medially.</p>