Dr. Rosenblum utilizes Clarius T-Mode Knee to evaluate a patient’s chronic infrapatellar knee pain, examining the medial meniscus, fat pads, and tendons for signs of degeneration. Accommodating the patient’s specific request, he then performs a targeted, ultrasound-guided injection directly into the infrapatellar region at the primary site of discomfort.
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This patient suffering with chronic knee pain is pain is basically infra patella. Medial and lateral. Mainly medial. I'm scanning the infra patellar tendon using the ai ai feature on my Clarus unit. I don't see any obvious pathologies behind the patella. You see, the fat pad to the right is the patella, and then the tibial tuberosity is to the left where the tendon inserts and you can see it's tapering down.
Examining the medial aspect of his knee I can find the meniscus which is highlighted with the T mode. We also see the medial collateral ligament above it, and I see the space between the joints. There is some slight degeneration, but he is not bone on bone, so
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he has some visible tissue between the bones.
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Now bend your knees slightly please.
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Okay. This is the super patella region.
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Where we have the super patellar tendon and the.
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Pre femoral fat pad. I'm going to turn it 90 degrees. You stay still. I'm just going to turn the probe 90 degrees.
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And here you can see the patella the super patellar tendon the.
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super patellar fat pad and the pre femoral fat pad. The joint space is connected to the hyper loosened black space between the fat pads. This is another way to access the knee.
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Okay. Normally I would go above the patella because usually that's painful. But the patient is requesting the injection right where the site of his pain is below the patella. Can you bend your knee more, please? Great. Thank you. So just to confirm, your pain is right here. Correct. 2D mode. Visualizing the knee in a sagittal plane.
The patella is on the top and the tibia tibia is on the bottom. I could come out of plane,
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or I could come in plane and turn the probe 90 degrees
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to follow the trajectory of the needle. You see a cross section of the patellar tendon.
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Right in the center.
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Little pinch.
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Capture image
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and getting a nice smooth injection. Is this the area of your pain? That's fine. Okay.
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Okay. Done.
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