<p begin="00:00:07.188" end="00:00:08.845" style="s2">- [Voiceover] A linear array transducer</p>
<p begin="00:00:08.845" end="00:00:11.064" style="s2">with a musculoskeletal exam type</p>
<p begin="00:00:11.064" end="00:00:13.476" style="s2">is used to perform an<br />ultrasound examination</p>
<p begin="00:00:13.476" end="00:00:15.738" style="s2">of the infrapatellar tendon.</p>
<p begin="00:00:15.738" end="00:00:17.577" style="s2">The patient is in a supine position</p>
<p begin="00:00:17.577" end="00:00:20.176" style="s2">with the knee flexed 90 degrees.</p>
<p begin="00:00:20.176" end="00:00:22.815" style="s2">The transducer is placed longitudinally</p>
<p begin="00:00:22.815" end="00:00:25.613" style="s2">just inferior to the<br />patella in the mid-line</p>
<p begin="00:00:25.613" end="00:00:26.858" style="s2">with the orientation marker</p>
<p begin="00:00:26.858" end="00:00:29.102" style="s2">directed to the patient's head.</p>
<p begin="00:00:29.102" end="00:00:31.030" style="s2">The bright hyperechoic patella</p>
<p begin="00:00:31.030" end="00:00:33.007" style="s2">is seen on the left of the image.</p>
<p begin="00:00:33.007" end="00:00:34.572" style="s2">The infrapatellar tendon</p>
<p begin="00:00:34.572" end="00:00:38.046" style="s2">is seen as a compact<br />fibrillar pattern structure</p>
<p begin="00:00:38.046" end="00:00:40.679" style="s2">which extends from the<br />patellar insertion distally</p>
<p begin="00:00:40.679" end="00:00:43.517" style="s2">to the anterior tibial tuberosity.</p>
<p begin="00:00:43.517" end="00:00:45.316" style="s2">The long axis examination</p>
<p begin="00:00:45.316" end="00:00:47.519" style="s2">is repeated medially and laterally</p>
<p begin="00:00:47.519" end="00:00:49.785" style="s2">to fully evaluate the tendon.</p>
<p begin="00:00:49.785" end="00:00:53.546" style="s2">The transducer is then rotated<br />90 degrees counter clockwise</p>
<p begin="00:00:53.546" end="00:00:55.964" style="s2">to obtain a short axis view.</p>
<p begin="00:00:55.964" end="00:00:59.087" style="s2">The infrapatellar tendon is<br />seen as a speckled pattern,</p>
<p begin="00:00:59.087" end="00:01:01.662" style="s2">elliptical structure distal to the patella</p>
<p begin="00:01:01.662" end="00:01:03.829" style="s2">and anterior to the tibia.</p>
<p begin="00:01:04.822" end="00:01:07.231" style="s2">The transducer is slowly moved distally</p>
<p begin="00:01:07.231" end="00:01:08.992" style="s2">as the tendon gradually thins</p>
<p begin="00:01:08.992" end="00:01:11.992" style="s2">to insert on the tibial tuberosity.</p>

<p begin="00:00:07.461" end="00:00:09.290" style="s2">- [Voiceover] A linear array transducer</p>
<p begin="00:00:09.290" end="00:00:11.314" style="s2">with a musculoskeletal exam type</p>
<p begin="00:00:11.314" end="00:00:13.933" style="s2">is used to perform an<br />ultrasound examination</p>
<p begin="00:00:13.933" end="00:00:16.052" style="s2">of the ilio-tibial band.</p>
<p begin="00:00:16.052" end="00:00:18.213" style="s2">The patient is in a supine position</p>
<p begin="00:00:18.213" end="00:00:20.812" style="s2">with the knee flexed 90 degrees.</p>
<p begin="00:00:20.812" end="00:00:23.354" style="s2">The transducer is placed longitudinally</p>
<p begin="00:00:23.354" end="00:00:26.365" style="s2">over the outer knee,<br />just proximal and medial</p>
<p begin="00:00:26.365" end="00:00:28.860" style="s2">to the fibular head at Gerdy's tubercle,</p>
<p begin="00:00:28.860" end="00:00:30.647" style="s2">with the orientation marker directed</p>
<p begin="00:00:30.647" end="00:00:32.635" style="s2">to the patient's head.</p>
<p begin="00:00:32.635" end="00:00:34.734" style="s2">The fibers of the ilio-tibial band</p>
<p begin="00:00:34.734" end="00:00:36.838" style="s2">are seen just superficial to the bright,</p>
<p begin="00:00:36.838" end="00:00:39.016" style="s2">hyperechoic Gerdy's tubercle.</p>
<p begin="00:00:39.016" end="00:00:41.254" style="s2">The ilio-tibial band is assessed</p>
<p begin="00:00:41.254" end="00:00:44.324" style="s2">as it cross the lateral femoral condyle.</p>
<p begin="00:00:44.324" end="00:00:47.169" style="s2">A small anechoic bursa may<br />be visible at this point</p>
<p begin="00:00:47.169" end="00:00:50.752" style="s2">in patients with<br />ilio-tibial band syndrome.</p>

<p begin="00:00:09.598" end="00:00:13.480" style="s2">- The next structure to<br />examine is the iliotibial band.</p>
<p begin="00:00:13.480" end="00:00:15.787" style="s2">The iliotibial band attaches distally</p>
<p begin="00:00:15.787" end="00:00:18.519" style="s2">at the Gerdy's tubercle.</p>
<p begin="00:00:18.519" end="00:00:21.179" style="s2">This injury is commonly<br />involved in active individuals,</p>
<p begin="00:00:21.179" end="00:00:23.043" style="s2">including runners.</p>
<p begin="00:00:23.043" end="00:00:25.462" style="s2">Important landmarks in the<br />transducer will always face</p>
<p begin="00:00:25.462" end="00:00:27.444" style="s2">superior with the notch.</p>
<p begin="00:00:27.444" end="00:00:30.242" style="s2">Secondly, to palpate Gerdy's tubercle,</p>
<p begin="00:00:30.242" end="00:00:32.575" style="s2">I begin at the fibular head.</p>
<p begin="00:00:34.524" end="00:00:37.857" style="s2">I move medially until I<br />feel a bony protuberance,</p>
<p begin="00:00:37.857" end="00:00:39.602" style="s2">which is the Gerdy's tubercle.</p>
<p begin="00:00:39.602" end="00:00:43.769" style="s2">I'm going to place the probe<br />directly over Gerdy's tubercle.</p>
<p begin="00:00:45.751" end="00:00:49.916" style="s2">Here I see the fibers<br />of the iliotibial band,</p>
<p begin="00:00:49.916" end="00:00:52.335" style="s2">attaching on Gerdy's tubercle.</p>
<p begin="00:00:52.335" end="00:00:55.502" style="s2">An ultrasound bone is bright white due</p>
<p begin="00:00:57.098" end="00:00:59.181" style="s2">to its reflective nature.</p>
<p begin="00:01:00.201" end="00:01:04.368" style="s2">This is a clear image showing<br />a healthy iliotibial band.</p>