Mskfreak-Msk Ultrasound Training

In musculoskeletal ultrasound, dynamic maneuvers are essential to distinguish a partial tear from a complete rupture.
In this case, the tibionavicular ligament shows focal thinning in its midportion, raising suspicion of an injury.
However, a static image alone is not always conclusive.
By asking the patient to perform plantarflexion and eversion, a visible gap becomes evident.
This dynamic finding confirms a complete tear of the tibionavicular ligament.
Key takeaway:
Don’t rely solely on the resting image.
Dynamic ultrasound can change the diagnosis.
It can make the difference between suspecting an injury and confirming a full-thickness tear.
In this case, dynamic testing allowed visualization of a clear separation between the ligament ends, confirming a complete tear.
✅ The static image suggests.
✅ The dynamic maneuver confirms.

Comparing with the contralateral side is always helpful.
In this case, the image is completely different: you can see an avulsion at the calcaneal insertion of the ligament, consistent with a complete tear of the calcaneofibular ligament.
A grade 3 injury.
This clip is part of the new Ankle Sprains course, available on 07/06 at mskfreak.com.

Short extract from an upcoming SK ultrasound course.

Patient referred after an ankle sprain.
Scanning the peroneus brevis tendon to its insertion at the base of the 5th metatarsos to rule out fractures.

Clinical ultrasound. Real cases. Coming soon.

MSKFREAK.COM

Acute ankle sprain in a professional soccer player during a match.

Ultrasound showed chronic ATFL changes, but the acute injury was different: rupture of the superior extensor retinaculum of the ankle, with some muscle herniation.

A good reminder: ankle sprains are not always just about the ATFL.

With US, we can evaluate all the soft tissues surrounding the joint. Other structures may be involved, and this can affect prognosis and treatment planning.

Clip from the upcoming ankle sprain course.

Soon at MSKFREAK.COM

FootballMedicine Ultrasound MSK SportsInjury

One of the keys when scanning the medial ankle: understanding the relationship between the tibialis posterior tendon and the spring ligament.

In this video we show a simple but very reproducible way to orient the probe, identify the 3 bony landmarks and confirm the spring ligament position on ultrasound.

This will be part of a new Foot & Ankle MSK Ultrasound Course, coming soon on mskfreak.com

Hope you find it useful.

A key point in anterior hip sonoanatomy: the iliopsoas tendon is not a single structure proximally. It is formed by two components — the psoas tendon and the iliacus tendon which fuse more distally.

Do you know the boundaries of the rotator interval?
In this video we review the key structures that define this clinically important region:
▸ Subscapularis — inferior border
▸ Supraspinatus — superior border
▸ Superior glenohumeral ligament — inferomedial border
▸ Coracohumeral ligament — superolateral border
▸ Long head of the biceps tendón — inside

Mskfreak.com | MSK Ultrasound Education

Diagnosing whether a calcification is truly causing shoulder pain is not always straightforward.
In this extract from the Shoulder Pathologies course, we try to provoque the patient’s symptoms through specific movements.
Internal rotation and abduction can help place the calcification under the acromion or coracoacromial ligament.
If this reproduces the patient’s pain, the calcification is likely part of the problem.
A small clinical detail that can guide better treatment decisions.
Extract from the Shoulder Pathologies course at mskfreak.com

👉 How to assess a calcification on ultrasound step by step

It’s not just about identifying it.
It’s about following a systematic diagnostic approach:

1️⃣ Measure it properly
➡️ Always in long axis and short axis

2️⃣ Localize it
➡️ Which tendon is it actually in? (use the short axis to confirm)

3️⃣ Classify its morphology
➡️ Farin classification helps you understand its behavior

4️⃣ Assess if it’s treatable
⚠️ Not all calcifications should be needled
(punctate or linear ones are not candidates)

5️⃣ Evaluate with Doppler and dynamic maneuvers
➡️ Is it symptomatic? Is there associated bursitis?

💡 This process is essential to properly characterize the calcification
and make the right clinical decisions.

🎥 Full video on YouTube → Link in Bio.