What is the ultrasound findings of calcific tendinosis?
Calcific tendinopathy, or calcific tendinosis, is an extremely painful condition caused by the deposition of calcium hydroxyapatite within or around a tendon. Calcium hydroxyapatite on radiographs appears as amorphous calcific densities.
On Ultrasound, calcium hydroxyapatite appears echogenic. It may be either amorphous or well defined, with or without posterior shadowing. It most commonly occurs around the shoulder but can occur anywhere a tendon inserts on bone.
An abscess may have a variety of appearances on US but typically presents as a fairly well-defined hypoechoic, heterogeneous fluid collection with increased posterior acoustic enhancement and peripheral hyperemia on Doppler imaging.
It is not uncommon to observe central foci/pockets of gas and a thickened, echogenic hyperemic abscess wall. The use of transducer pressure to induce the swirling of internal contents is helpful to differentiate an abscess from a seroma.
Additionally, changing scanning parameters such as increasing the field of view and depth may make posterior acoustic enhancement through a suspected abscess appear more conspicuous compared to adjacent background structures.