My report says 'tendinosis' not 'tendinitis.' What is the difference?

Tendinitis is acute inflammation of the tendon that responds well to rest and anti-inflammatories. Tendinosis is chronic degeneration without inflammation, characterized by collagen disorganization. It requires different treatment: PRP, shockwave therapy, eccentric exercises. Dr Bolduc will explain the approach best suited to your case.

Are all hypoechoic areas abnormal?

Not necessarily. Some normal structures are hypoechoic (muscles, blood vessels). It is the combination of clinical context, location, and measurements that determines whether a hypoechoic area is pathological. This is why interpretation by a specialist is essential.

My report mentions a '30% partial tear.' What does that mean?

This means the tear affects 30% of the total tendon thickness. Generally, tears under 50% can be treated conservatively (rest, physiotherapy, PRP). Tears over 50% or those that do not heal may require a PRP injection or surgical consultation.

Can I get my ultrasound report explained over the phone?

Dr Bolduc prefers to explain results in person during a consultation so he can show you the images and answer all your questions. However, for established patients, a phone explanation is sometimes possible. Contact the clinic at 8131 boul. Cousineau, Saint-Hubert to discuss.

How to Understand Your Musculoskeletal Ultrasound Report: A Patient's Guide

Musculoskeletal Ultrasound: A Powerful Diagnostic Tool

Musculoskeletal ultrasound is a medical imaging exam that uses sound waves to visualize tendons, muscles, ligaments, bursae, and joints. At the Clinique de médecine musculo-squelettique of Dr Sébastien Bolduc, ultrasound is used daily to precisely diagnose tendon, muscle, and joint pathologies, and to guide cortisone injections, PRP, and other interventions.

Your ultrasound report may seem intimidating with its technical terms. This guide will help you understand the most common terms so you can discuss your results knowledgeably with your physician.

Echogenicity Terms: Hypoechoic and Hyperechoic

These terms describe how tissues appear on the ultrasound image based on their ability to reflect sound waves (echogenicity).

Hyperechoic: a structure that appears white or bright on the screen. Bones, calcifications, and dense fibrous tissue are hyperechoic. A normal tendon appears hyperechoic with a regular fibrillar pattern.
Hypoechoic: a structure that appears darker than surrounding tissues. Fluid (blood, synovial fluid) is hypoechoic. A pathological tendon (tendinitis, tendinosis) appears hypoechoic, thickened, with loss of normal fibrillar architecture.
Anechoic: completely black — typical of free fluid. A fluid collection (cyst, effusion) is anechoic.
Heterogeneous: a mix of different appearances. A tendon with calcifications and tear areas will be described as heterogeneous.

Common Diagnoses in Your Report

Tendinosis: chronic tendon degeneration without significant inflammation. The report will mention a thickened, hypoechoic tendon with loss of fibrillar architecture. Unlike tendinitis (acute inflammation), tendinosis is a degenerative process that responds better to PRP, shockwave therapy, and eccentric exercises than to anti-inflammatories.

Tendon tear (or rupture): can be partial (affecting part of the tendon) or complete (tendon torn in two). The report will specify the percentage of tendon thickness involved, the location, and the presence of a gap between the two ends. A complete tear often requires surgery, while a partial tear can be treated conservatively.

Joint effusion: abnormal fluid in a joint. The report will indicate the amount (minimal, moderate, large) and location. Effusion often accompanies arthritis, trauma, or joint inflammation.

Bursitis: inflammation of a bursa. The report will describe a thickened bursa (usually more than 2 mm), hypoechoic, sometimes with fluid. Bursitis responds very well to ultrasound-guided cortisone injections.

Tendon calcification: calcium deposit in the tendon, visible as a hyperechoic area sometimes with an acoustic shadow. Common in the rotator cuff (calcific tendinopathy of the shoulder). Shockwave therapy is particularly effective for this type of calcification.

What Do the Measurements Mean?

The report may include measurements in millimeters. For example:

Tendon thickness: a normal Achilles tendon measures about 5 to 6 mm in thickness. Beyond 7 mm, this is considered pathological thickening.
Effusion: a fluid pocket larger than 3 mm is generally considered significant.
Calcification size: a calcification larger than 10 mm may require specific treatment.
Retraction distance: in case of complete rupture, the distance between the two tendon ends is measured to assess the need for surgery.

Remember that interpretation of your report must always be done by a specialized physician. Dr Sébastien Bolduc takes the time to explain your ultrasound results in detail during your consultation at the Clinique de médecine musculo-squelettique (8131 boul. Cousineau, Saint-Hubert).