New technologies applied to ultrasound diagnosis of sports injuries

The aim of this study was to compare the ultrasound images of different soft tissue lesions from two different portable sonography devices: a conventional portable sonography device (ultrasound [US]-A, Micromaxx model; Sonosite Inc., Bothell, WA, USA), and a recently marketed compact device (US-B, Logiq e; General Electric Healthcare, Wauwatosa, WI, USA). The US-B device uses the new technologies of tissue harmonic imaging, real-time compound ultrasound, panoramic view, three-dimensional imaging, and virtual convex imaging. We compared ultrasound images of six different types of soft tissue lesions (muscle contusion, muscle strain, patellar tendinosis, calcifying patellar tendinosis, rupture of the lateral internal ligament of the knee, and deep infrapatellar synovial bursa), from six different subjects. Analysis of images was performed by the same ultrasound specialist. In accordance with the classical criteria for ultrasound studies, the following quantitative indicators and parameters of ultrasound quality were used to evaluate the images: degree of echogenicity, size of the lesion area, aspect, shape, borders, and overall visualization. In muscle lesions due to contusion, not only is the edematous area better visualized with the new system, but definition of hemorrhagic area borders and their content is especially increased. In lesions of the tendons, the new system affords better definition of the borders of the hypoechogenic area of tendinous degeneration and perfect visualization of the extension of the damaged area using a panoramic study. Sonographic study of ligaments with chronic lesions permits visualization of scar areas. Finally, use of the new system with a small synovial bursa shows the content of the bursa and thickness of the walls more clearly. Overall, the quantitative indicators and parameters of image quality performed in this study of common sports lesions demonstrate the improvement in visualization of damaged soft tissues with the new technologies now incorporated into portable sonography devices.