Secondary Logo

Journal Logo

Video Gallery

Adding a Transverse Scan in the Ultrasound Diagnosis of Extensor Tendinopathy

Video Author: Yi-Chian Wang, Rachel J. Lew, Chia-Wei Lee, Yi-Pin Chiang
Published on: 08.04.2016

Extensor Tendinopathy (Tennis Elbow) is a common term used to describe pathology of the forearm extensor tendons that converge to anchor the muscles to the lateral elbow. During traditional ultrasonography using the longitudinal scanning method, it is difficult to determine which component of the common extensor tendon (CET) is affected. This video presents the addition of a transverse scan to better visualize the tendons that join and form the CET. Two cases seen in our ultrasound clinic were demonstrated. The findings from the transverse scan helped to provide modifications of specific wrist and hand activities to facilitate recovery.

All Videos
Most Viewed
Most Emailed



Creator: Eric Altschuler, MD, PhD
Duration: 0:22
This video shows subtle dysmetria on the finger-to-nose test in the right hand: The patient loses the smooth trajectory about 75% of the way through the reaching process, then has small amplitude oscillations before reaching the target. (Normal left hand finger-to-nose.)
Creator: Chueh-Hung Wu
Mathieu Boudier-Revéret
Duration: 2:27
Two cases referred as “piriformis syndrome” which received needling of gluteus maximus and piriformis, showing prominent twitch responses in GMax only.
Creator: Byung Joo Lee & Donghwi Park
Duration: 0:28
Video 1: This is a dynamic ultrasonography of normal individual. Posterosuperior labrum appears as a fibrillary hyperechoic triangle, coursing around the shoulder joint capsule. During the ABER maneuver, there was no detachment of labrum or joint fluid leakage, although the PS labrum was pressed slightly by the pressure from ABER posture.
Creator: Byung Joo Lee & Donghwi Park
Duration: 0:35
Video 2: This is a dynamic ultrasonography of a 36-year-old man with posterosuperior labral tear. Although the PS labrum appears as a fibrillary hyperechoic triangle in neutral position, hypoechoic lesion is distinct in PS labrum. During the ABER maneuver, leakage of the joint fluid through torn PS labrum can be seen. In this case the fluid flow through the tear is admittedly a subtle finding and the presence of a GHJ effusion (not seen in this case) may make this examination more difficult.
Creator: Chueh-Hung Wu, Mathieu Boudier-Revéret
Duration: 2:28
The case of a 26-year-old man with lateral antebrachial cutaneous nerve entrapment within a post-surgical scar at the forearm is presented with both diagnostic and therapeutic ultrasound images.
Creator: Wei-Ting Wu
Duration: 00:35
Using a curvilinear transducer in the oblique coronal plane, and the probe is placed between the coracoid process and acromioclavicular joint. A hypoechoic slip inside the hyperechoic triangular labrum is identified. Proximal portion of the biceps tendon (long head) appeared intact. With forcefully pulling the arm downward, the slip was enlarged with fluid filling the gap.
Creator: James Hallinan, Edward Smitaman and Brady Huang
Duration: 1:53
This video shows dynamic ultrasound images with real-time ankle movements. Dynamic scanning in the transverse view showed peroneus longus muscle herniation at the lateral leg during ankle dorsiflexion and eversion. A corresponding MRI also shows the muscle herniation.
Creator: Tsung-Yung Tang; Shau-Gang Shyu; Chueh-Hung Wu
Duration: 2:19
This video demonstrates an ultrasound-guided 5-in-1 injection for trigger point injection in the trapezius, levator scapulae and rhomboid muscles, and nerve hydrodissection of the spinal accessory nerve and dorsal scapular nerve for a patient with upper back pain with neuropathic characteristics.
Creator: Daniel M Cushman, MD
Duration: 0:16
This video demonstrates needle electromyography on a patient with respiratory synkinesis, with a needle in the right biceps brachii muscle. The first section of the video shows a relaxed patient, with the appearance of motor units associated with the inhalation phase of breathing. Next, the electromyographer asks her to take a deep breath with subsequent activation of numerous atypical motor units, which is done three times. For the last section, the patient holds her breath, and the motor unit stops firing.
Creator: Yi-Chian Wang, Shaw-Gang Shyu, Chueh-Hung Wu, Tyng-Guey Wang
Duration: 1:52
This video showed the axial and sagittal ultrasound-guided injection to the cricopharyngeal muscle, and showed the videofluoroscopic swallowing study results before and after the injection.
Creator: Tze Chao Wee, Chueh-Hung Wu
Duration: 1:05
The video provides a brief background to the pa-tient’s presentation, management and follow up. This is accompanied by 2 clips showing the ultra-sound tracking of the affected posterior interosse-ous nerve and the sound side.
Creator: Ke-Vin Chang
Duration: 1:00
The video demonstrated tracking a swollen extensor carpi ulnaris tendon with a thickened retinaculum. An enlarged nerve segment with loss of fascicular echotexture was observed, and was impinged by the thickened retinaculum.
Creator: The video demonstrated tracking the brachial plexus from the supraclavicular to root level and ultrasound guided injection to the cervical roots of C5 and C6.
Duration: 2:39
The video demonstrated tracking the brachial plexus from the supraclavicular to root level and ultrasound guided injection to the cervical roots of C5 and C6.
Creator: Carl PC CHEN
Duration: 4:08
This video shows how ultrasound-guided cervical nerve root block (US-CRB) is done to the 5th nerve root level. The objective of CRB is to place the needle in the intertubercular groove situated between the nerve root and the posterior tubercle.
Creator: Ke-Vin Chang
Duration: 3:07
The video demonstrates the anatomy of the superior cluneal nerve and the ultrasonographic technique for imaging and injecting the superior cluneal nerve.
Creator: Yi-Chian Wang, Rachel J. Lew, Chia-Wei Lee, Yi-Pin Chiang
Duration: 3:37
Extensor Tendinopathy (Tennis Elbow) is a common term used to describe pathology of the forearm extensor tendons that converge to anchor the muscles to the lateral elbow. During traditional ultrasonography using the longitudinal scanning method, it is difficult to determine which component of the common extensor tendon (CET) is affected. This video presents the addition of a transverse scan to better visualize the tendons that join and form the CET. Two cases seen in our ultrasound clinic were demonstrated. The findings from the transverse scan helped to provide modifications of specific wrist and hand activities to facilitate recovery.
Creator: Murat Karkucak
Duration: 1:51
AN ULTRASOUND VIDEO DEMONSTRATION FOR LUMBAR FACET JOINT INJECTION
Creator: Ke-Vin Chang
Duration: 0:39
The image revealed a flattened compressible mass superficial to the flexor tendon on the 3rd metatarsophalangeal joint. Slightly relocating the transducer toward the heel, we found another mass emerging from the 3rd intermetatarsal space, a common region for Morton’s neuroma. Under dynamic tracking, the connecting stalk between the intermetatarsal mass and the lesion overlying the 3rd toe flexor tendon might be considered as another hint for tendon-sheath related pathology. Its heteroechoic appearance and hypervasculairty were compatible with submetatarsal bursitis.
Creator: Ming-Yen Hsiao, Chen-Yu Hung, Ke-Vin Chang, Levent Özçakar
Duration: 0:29
Tracking of the the long head of the biceps tendon from the bicipital groove to the proximal insertion of the superior labrum.
Creator: Ming-Yen Hsiao, Chen-Yu Hung, Ke-Vin Chang, Levent Özçakar
Duration: 0:12
Dynamic examination of the the long head of the biceps tendon at the proximal insertion is performed by supinating and pronating the forearm while keeping the upper arm fixed.



Creator: Eric Altschuler, MD, PhD
Duration: 0:22
This video shows subtle dysmetria on the finger-to-nose test in the right hand: The patient loses the smooth trajectory about 75% of the way through the reaching process, then has small amplitude oscillations before reaching the target. (Normal left hand finger-to-nose.)
Creator: Chueh-Hung Wu
Mathieu Boudier-Revéret
Duration: 2:27
Two cases referred as “piriformis syndrome” which received needling of gluteus maximus and piriformis, showing prominent twitch responses in GMax only.
Creator: Byung Joo Lee & Donghwi Park
Duration: 0:28
Video 1: This is a dynamic ultrasonography of normal individual. Posterosuperior labrum appears as a fibrillary hyperechoic triangle, coursing around the shoulder joint capsule. During the ABER maneuver, there was no detachment of labrum or joint fluid leakage, although the PS labrum was pressed slightly by the pressure from ABER posture.
Creator: Byung Joo Lee & Donghwi Park
Duration: 0:35
Video 2: This is a dynamic ultrasonography of a 36-year-old man with posterosuperior labral tear. Although the PS labrum appears as a fibrillary hyperechoic triangle in neutral position, hypoechoic lesion is distinct in PS labrum. During the ABER maneuver, leakage of the joint fluid through torn PS labrum can be seen. In this case the fluid flow through the tear is admittedly a subtle finding and the presence of a GHJ effusion (not seen in this case) may make this examination more difficult.
Creator: Chueh-Hung Wu, Mathieu Boudier-Revéret
Duration: 2:28
The case of a 26-year-old man with lateral antebrachial cutaneous nerve entrapment within a post-surgical scar at the forearm is presented with both diagnostic and therapeutic ultrasound images.
Creator: Wei-Ting Wu
Duration: 00:35
Using a curvilinear transducer in the oblique coronal plane, and the probe is placed between the coracoid process and acromioclavicular joint. A hypoechoic slip inside the hyperechoic triangular labrum is identified. Proximal portion of the biceps tendon (long head) appeared intact. With forcefully pulling the arm downward, the slip was enlarged with fluid filling the gap.
Creator: James Hallinan, Edward Smitaman and Brady Huang
Duration: 1:53
This video shows dynamic ultrasound images with real-time ankle movements. Dynamic scanning in the transverse view showed peroneus longus muscle herniation at the lateral leg during ankle dorsiflexion and eversion. A corresponding MRI also shows the muscle herniation.
Creator: Tsung-Yung Tang; Shau-Gang Shyu; Chueh-Hung Wu
Duration: 2:19
This video demonstrates an ultrasound-guided 5-in-1 injection for trigger point injection in the trapezius, levator scapulae and rhomboid muscles, and nerve hydrodissection of the spinal accessory nerve and dorsal scapular nerve for a patient with upper back pain with neuropathic characteristics.
Creator: Daniel M Cushman, MD
Duration: 0:16
This video demonstrates needle electromyography on a patient with respiratory synkinesis, with a needle in the right biceps brachii muscle. The first section of the video shows a relaxed patient, with the appearance of motor units associated with the inhalation phase of breathing. Next, the electromyographer asks her to take a deep breath with subsequent activation of numerous atypical motor units, which is done three times. For the last section, the patient holds her breath, and the motor unit stops firing.
Creator: Yi-Chian Wang, Shaw-Gang Shyu, Chueh-Hung Wu, Tyng-Guey Wang
Duration: 1:52
This video showed the axial and sagittal ultrasound-guided injection to the cricopharyngeal muscle, and showed the videofluoroscopic swallowing study results before and after the injection.
Creator: Ke-Vin Chang
Duration: 1:00
The video demonstrated tracking a swollen extensor carpi ulnaris tendon with a thickened retinaculum. An enlarged nerve segment with loss of fascicular echotexture was observed, and was impinged by the thickened retinaculum.
Creator: The video demonstrated tracking the brachial plexus from the supraclavicular to root level and ultrasound guided injection to the cervical roots of C5 and C6.
Duration: 2:39
The video demonstrated tracking the brachial plexus from the supraclavicular to root level and ultrasound guided injection to the cervical roots of C5 and C6.
Creator: Ke-Vin Chang
Duration: 3:07
The video demonstrates the anatomy of the superior cluneal nerve and the ultrasonographic technique for imaging and injecting the superior cluneal nerve.
Creator: Yi-Chian Wang, Rachel J. Lew, Chia-Wei Lee, Yi-Pin Chiang
Duration: 3:37
Extensor Tendinopathy (Tennis Elbow) is a common term used to describe pathology of the forearm extensor tendons that converge to anchor the muscles to the lateral elbow. During traditional ultrasonography using the longitudinal scanning method, it is difficult to determine which component of the common extensor tendon (CET) is affected. This video presents the addition of a transverse scan to better visualize the tendons that join and form the CET. Two cases seen in our ultrasound clinic were demonstrated. The findings from the transverse scan helped to provide modifications of specific wrist and hand activities to facilitate recovery.
Creator: Murat Karkucak
Duration: 1:51
AN ULTRASOUND VIDEO DEMONSTRATION FOR LUMBAR FACET JOINT INJECTION
Creator: Ming-Yen Hsiao, Chen-Yu Hung, Ke-Vin Chang, Levent Özçakar
Duration: 0:29
Tracking of the the long head of the biceps tendon from the bicipital groove to the proximal insertion of the superior labrum.
Creator: Ming-Yen Hsiao, Chen-Yu Hung, Ke-Vin Chang, Levent Özçakar
Duration: 0:12
Dynamic examination of the the long head of the biceps tendon at the proximal insertion is performed by supinating and pronating the forearm while keeping the upper arm fixed.
Creator: Ming-Yen Hsiao, Chen-Yu Hung, Ke-Vin Chang, Levent Özçakar
Duration: 0:11
Dynamic stress test of the the long head of the biceps tendon by applying an inferior distraction force to the humerus.
Creator: Ming-Yen Hsiao, Ke-Vin Chang , Levent Özçakar
Duration: 1:01
Dynamic ultrasonography of anterior cruciate ligament from knee flexion to extension and extension to flexion.
Creator: Ming-Yen Hsiao, Ke-Vin Chang , Levent Özçakar
Duration: 0:15
Dynamic ultrasonography of anteromedial bundle of anterior cruciate ligament with a simultaneous anterior drawer test
Creator: Ming-Yen Hsiao, Ke-Vin Chang , Levent Özçakar
Duration: 0:15
Dynamic ultrasonography of posterolateral bundle of anterior cruciate ligament with a simultaneous anterior drawer test
Creator: Thiru M. Annaswamy, Kimberly Davis, Corey Armstead
Duration: 0:06
Needle electromyography in low cervical paraspinal muscles of a patient with EMG disease demonstrate increased insertional activity and myotonic discharges at 2 different sweep speeds; 20ms (video 1) and 500ms (video 2). Video 1: 20ms sweep displays a myotonic discharge that can appear as fibrillations and positive sharp waves or complex repetitive discharges. Video 2: 500ms sweep reveals the “wax and wane” characteristic specific to myotonic discharges. Myotonic discharges can have variable appearance and sound depending on sweep speed. By definition discharges need to last over 500ms and in 3 or more areas outside of an endplate.
Creator: Thiru M. Annaswamy, Kimberly Davis, Corey Armstead
Duration: 0:29
Needle electromyography in low cervical paraspinal muscles of a patient with EMG disease demonstrate increased insertional activity and myotonic discharges at 2 different sweep speeds; 20ms (video 1) and 500ms (video 2). Video 1: 20ms sweep displays a myotonic discharge that can appear as fibrillations and positive sharp waves or complex repetitive discharges. Video 2: 500ms sweep reveals the “wax and wane” characteristic specific to myotonic discharges. Myotonic discharges can have variable appearance and sound depending on sweep speed. By definition discharges need to last over 500ms and in 3 or more areas outside of an endplate.
Creator: Hung-Jui Chuang, Ming-Yen Hsiao, Chueh-Hung Wu, Levent Özçakar
Duration: 1:29
Ulnar nerve subluxation or snapping triceps syndrome is the condition of anterior sliding of the ulnar nerve or part of the triceps muscle over the medial epicondyle during elbow flexion. This video presents the real-time dynamic visualization of the entire process of ulnar nerve subluxation and snapping triceps during joint movement of the elbow using ultrasonography.
Creator: Chen-Yu Hung
Duration: 0:41
Demonstration of the dynamic stress test of both the normal and injured wrists as well as the Doppler ultrasound imaging of the injured TFCC.
Creator: Yi-Hsuan Hung, Chueh-Hung Wu, Levent Özçakar, Tyng-Guey Wang
Duration: 1:37
This video showed dynamic scanning (transverse view) of two painful neuromas at the level of stump tip of a below-elbow amputee. After ultrasound-guided perineural steroid injections, the sizes of both neuromas decreased during follow up one month later. The patient also reported a marked reduction in pain and numbness of the stump tip and well tolerated an electronic arm prosthesis.
Creator: Jia-Pei, Hong, MD, Henry L. Lew, MD, PhD, Chih-Hong, Lee, MD, Simon F.T. Tang, MD,
Duration: 2:06
The authors demonstrated ultrasound-guided technique in treating carpal tunnel syndrome to avoid damaging the median nerve and adjacent soft tissue. Since the median nerve goes deeper at distal hamate level, distal approach may provide larger space for initial needle insertion. Under long-axial view, the whole stretch of median nerve could be visualized when the needle progressed proximally in the access of in-plane.
Creator: Carl PC CHEN
Duration: 2:14
Injection treatment to the glenohumeral joint is often needed to treat shoulder problems such as adhesive capsulitis. This can be done through blind palpation technique, fluoroscopic or musculoskeletal ultrasound guidance. In recent years, ultrasound has been proven to increase the accuracy of needle placement into the glenohumeral joint.
Glenohumeral joint injection can be done through the anterior rotator interval approach or the posterior approach techniques. The posterior injection technique offers an easier and a more effective approach to the glenohumeral joint with less extravasation rate as compared with the anterior approach. The video demonstrates how the posterior injection approach is done through ultrasound guidance.
Creator: YI-Pin Chiang
Wen-Hsiang Tsai
Rachel Lew
Duration: 4:26
This video briefly reviewed the anatomy and sonographic appearance of knee ligaments, including two collateral ligaments and two cruciate ligaments. Ultrasound guided injection and aspiration for the knee joint was also demonstrated.
Creator: Alberto Esquenazi, MD
Duration: 0:52
Video demonstration of a patient using ReWalk. The ReWalk is a lower limb powered exoskeleton that allows thoracic or lower level motor-complete individuals with SCI to walk independently.
Creator: Ming-Yen Hsiao, Shaw-Gang Shyu, Chueh-Hung Wu, Levent Özçakar
Duration: 1:15
The video shows dynamic ultrasound imaging for type A intrasheath subluxation of the peroneal tendons. Transposition of the peroneal longus and brevis tendons during ankle dorsiflexion and evertion is demonstrated.
Creator: Kai-Shiang Chang, Yu-Hsuan Cheng, Chueh-Hung Wu, Levent Özçakar
Duration: 4:10
This video shows the dynamic images for the iliotibial band snapping hip syndrome, which could not be detected by the MRI exam. If an individual has lateral hip pain and correlated history, dynamic ultrasound imaging is the best modality to diagnose iliotibial band snapping hip syndrome.
Creator: Chueh-Hung Wu
Shaw-Gang Shyu
Levent Özçakar
Tyng-Guey Wang
Duration: 0:56
This video showed the real-time ankle movements and the ultrasound images. Dynamic scanning (transverse view) at the level of the lateral malleolus showed anterior subluxation of the peroneal longus tendon over the malleolus during dorsiflexion and eversion. The peroneus longus tendon returned to the normal anatomic position at rest.
Creator: Tomokazu Takakura
Duration: 0:08
Video demonstrates popping-up performed by an experienced surfer.
Creator: Chih-Kuang Chen, MD, Henry L. Lew, MD, PhD.
Duration: 4:09
From an upcoming issue of the American Journal of Physical Medicine & Rehabilitation
Creator: Yi-Pin Chiang, Shiau-Fu Hsieh, Henry L. Lew
Duration: 4:09
The Role of Ultrasonography in the Differential Diagnosis and Treatment of Tennis Elbow
Creator: Yi-Pin Chiang, MD, Chien-Fei Feng, MD, and Henry L. Lew, MD, PhD
Duration: 4:12

With the July issue of the Journal we are launching a new regular feature: the Video Gallery. The purpose of this Gallery is to combine text with video in the presentation and discussion of a topic of interest in musculoskeletal medicine. The first publication is authored by Chiang and collaborators who made a fantastic effort to write the text and produce the video in a relatively short period of time so we could include it in this issue of the Journal. This first “combined media publication” focus on the use of ultrasound for the examination of the rotator cuff and injection of the subacromial and subdeltoid bursa. Thanks to the effort of the Publisher LWW, the video can be accessed using your smartphone camera QR reader App to scan and capture the QR Code included with the print version of the article or by visiting our website at www.AJPMR.com. I hope you will appreciate this new feature and send us your comments and suggestions for future topics and use of electronic media.

Walter R. Frontera, MD, PhD
Editor-in-Chief