Diagnostic Ultrasound Knee Assessment

Close up of a knee ultrasound

Diagnostic Knee Ultrasound services offered in Portland, OR, Bellevue, WA and Tempe, AZ

Sometimes, knee pain can develop as a result of overexertion or injury. But other times, you may not know the cause. Diagnostic ultrasound is a painless medical procedure that allows a medical provider to examine a patient’s knee and check for joint degeneration. The team at Reflex Knee Specialists offers comprehensive knee evaluations and non-surgical treatments for knee pain in Arizona, Oregon, and Washington State. Learn more about this service and why it’s so important.

How does Ultrasound Identify the Source of Knee Pain?

A diagnostic knee ultrasound is a painless imaging test. Using sound waves that humans can’t hear, an ultrasound machine generates images of the soft tissues inside the knee joint. Ultrasound images can help identify injuries to tendons or ligaments, cartilage damage, inflammation, bone spurs, cysts, abnormal collections of fluid inside the joint (effusions), and structural abnormalities. These findings on ultrasound help doctors identify the underlying causes of knee pain. Knee ultrasounds can also be used for a preventive evaluation to check for signs of cartilage damage years before symptoms appear, allowing patients to get treatment before irreversible damage has occurred. Diagnostic ultrasound is painless, noninvasive, and can be performed at a medical clinic in just a few minutes.

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Common Knee Conditions

If a patient has a knee injury or condition that’s causing knee pain, an ultrasound may be recommended to help determine the cause of pain and guide treatment. Ultrasound of the knee is used to help diagnose conditions like:


A bursa is a fluid-filled sac that cushions the knee joint. When it becomes irritated from overuse, it can lead to pain and swelling in the knee. Bursitis can develop from repetitive motions that put stress on the knees, like yard work or tennis.

Cartilage Damage

Cartilage is the flexible tissue that protects the ends of bones and allows them to move smoothly when articulating with each other. A sudden injury can damage the cartilage in the knee, or it may slowly break down over time. Cartilage damage can cause joint pain and stiffness or a sensation that the knee joint is clicking, catching, or giving out.


A cyst is a fluid-filled growth that can appear anywhere in the body. The most common type of cyst in the knee is a Baker’s cyst or popliteal cyst. When the knee produces too much fluid because of arthritis or cartilage damage, this type of cyst can develop. A Baker’s cyst may cause swelling, stiffness, and knee pain in the back of the knee.

Hoffa’s Impingement Syndrome

This condition develops when the fatty tissue below the patella (knee cap) gets pinched or injured. Also known as fat pad impingement, it causes pain below the patella (kneecap) and usually gets worse after physical activity.

Ligament Strain or Tears

The knee joint has four major ligaments:

  • Anterior cruciate ligament (ACL)
  • Posterior cruciate ligament (PCL)
  • Medial collateral ligament (MCL)
  • Lateral collateral ligament (LCL)

Sudden twisting motions or direct hits to the knee can damage these ligaments. ACL injuries are the most common. Ligament strains and tears most often happen in sports like soccer or football.

Meniscal Tears

The meniscus is a pad of fibrocartilage that acts as a shock absorber between the femur and tibia. It can get torn if a person quickly pivots or turns their leg. The most common type of meniscal tear is a degenerative tear, which is caused by destabilization of the meniscal tissue in the presence of chronic inflammation.  A patient with a torn meniscus may have difficulty bending and straightening their leg and can experience pain and swelling.


The knees are the joints most commonly affected by osteoarthritis (OA), which is the most common cause of knee pain.  OA is characterized by chronic inflammation, which causes cartilage to break down over time. This leads to pain, swelling, and stiffness, and eventual destruction of the entire knee joint.  Osteoarthritis is most commonly seen in people who have had a prior knee injury (such as ACL or meniscal tear), played sports, and in people over age 50.  


The synovium is the connective tissue that lines the inside of a joint. When the synovium in the knee becomes inflamed, a condition known as synovitis, patients usually experience joint pain. Synovitis can be caused by inflammatory arthritis or an injury.

Tendon Damage

Tendons are flexible tissues that connect muscles to bones. The tendons that provide support to the knee can get damaged while playing sports or during activities at work that involve repetitive squatting, kneeling, or bending. Some patients develop tendinitis, in which a tendon becomes inflamed and causes pain with movement. 

Benefits of a Diagnostic Ultrasound

Getting a diagnostic knee ultrasound has many advantages for the long term health and longevity of your knees. These include:

  • Efficiency: A diagnostic knee ultrasound can be completed in about 20 minutes, and results are available right away.
  • Low risk: Unlike an X-ray, ultrasound technology doesn’t use ionizing radiation, so it’s a very safe option for evaluating knee problems.
  • Dynamic imaging: Unlike an MRI, which offers a static view of the knee joint, a diagnostic ultrasound can capture dynamic images when the joint is in motion.
  • Non-invasive: An ultrasound allows a doctor to assess the structure of the muscles, tendons, and ligaments without making incisions.
  • Detect joint degeneration: An ultrasound can identify joint degeneration even before symptoms appear, allowing patients to be treated early, when treatments are the most effective.

The providers at Reflex Knee Specialists understand that knee arthritis may be caused by any number of factors and present in several ways. Scheduling routine examinations and discussing concerns or changes in knee performance with a knee specialist are some of the best ways for a patient to stay on top of their joint health.

When to See Medical Provider

Minor knee pain can often be managed with rest. But if you have recurring pain or experience an injury, it’s best to see a medical provider experienced in diagnosing and treating knee pain. Schedule an appointment for evaluation if you have:

  • Significant swelling in the knee joint
  • Redness or tenderness
  • Fever
  • Loss of function or reduced range of motion
  • Pain with everyday activities, such as going up and down stairs
  • Discomfort when exercising or playing sports
  • Pain or stiffness after sitting or standing for long periods

What to Expect at Your Ultrasound Appointment

At Reflex Knee Specialists, we have the equipment to perform ultrasound imaging on-site. On the day of your imaging appointment, we recommend wearing loose-fitting, comfortable shorts or pants that can be pushed up to fully expose your knee. You will sit on an exam table or in a treatment chair. A provider will apply ultrasound gel to your knee, which helps transmit sound waves. They will then use a handheld transducer to view images on the ultrasound monitor. The provider will move the transducer across your knee joint to view images of:

  • Bones
  • Cartilage
  • Meniscus
  • Tendons
  • Ligaments
  • Synovium (joint lining)
  • Cysts
  • Effusions (abnormal collections of joint fluid due to inflammation)
  • Hoffa’s Fat Pad

You may need to move your knee into different positions during the evaluation. The procedure isn’t painful, but certain knee movements may be uncomfortable. During your diagnostic ultrasound, the provider will review the images with you. Based on their findings, a customized treatment plan will be recommended for your knee pain. The whole procedure takes just a few minutes, and you can return to work or resume normal activities immediately afterward.

Follow-up Treatment

Diagnostic ultrasound can identify signs of injury, disease, or inflammation. The ultrasound images will help guide your personalized treatment plan. Reflex Knee Specialists offers innovative non-surgical treatments including:

As you move through a treatment plan, your Reflex provider may perform additional ultrasound exams to track your progress and to assess your response to treatment.

Annual Knee Ultrasounds

Some patients are more at risk of developing degenerative joint disease than others. These patients can benefit from regular ultrasound assessments to identify underlying issues before symptoms develop. An annual knee ultrasound can benefit patients with the following risk factors:

  • Lifestyle factors: Patients who currently play or have played competitive sports; people who have physically demanding jobs.
  • Age: The risk of developing arthritis increases with age.
  • Gender: Women are more likely than men to have knee osteoarthritis.
  • Obesity: Being overweight puts extra stress on the knees; additionally, adipose tissue releases pro-inflammatory factors that contribute to the chronic inflammation inside the joints.

Even if you aren’t currently experiencing knee pain, an annual ultrasound evaluation might be necessary if you have one or more risk factors. At Reflex Knee Specialists, we strive to proactively diagnose knee conditions, even before symptoms begin to appear. Preventing additional decline is key to preserving joint function. 

Schedule a Consultation with a Knee Specialist Today

With state-of-the-art facilities and advanced non-surgical treatment options, the medical team at Reflex Knee Specialists is dedicated to helping every patient preserve long-term knee health. Reflex Knee Specialists serves patients in Bellevue, Washington, Portland, Oregon and Tempe, Arizona. For more information or to schedule a knee evaluation appointment, call or contact us today.

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