Table 3

Ultrasonographic and elastographic parameters of the common extensor tendon at the lateral aspect of the elbow

ParametersMeasurements
Maximal tendon thickness*Centimetres (cm)
Tendon echogenicity†Grade 0: normal
Grade 1: hypoechogenicity <30%
Grade 2: hypoechogenicity 30%–70%
Grade 3: hypoechogenicity>70% and anechoic fissures
Grade 4: full-thickness tear or complete tendon detachment
EnthesophyteGrade 0: absent
Grade 1: present
Tendon calcificationsGrade 0: absent
Grade 1: hyperechogenic without acoustic shadowing
Grade 2: hyperechogenic with acoustic shadowing
Color Doppler ultrasound‡Grade 0: no pixel
Grade 1: a few pixels
Grade 2: ≤50% of the tendon surface
Grade 3: >50% of the tendon surface
Power Doppler ultrasound‡Grade 0: no pixel
Grade 1: a few pixels
Grade 2: ≤50% of the tendon surface
Grade 3: >50% of the tendon surface
Radial collateral ligament echostructureGrade 0: normal
Grade 1: hypoechogenic, thickened, irregular or partial tear
Grade 2: complete tear
ARFI-mode elastographyMean shear wave velocity
  • Long axis of tendon

  • Short axis of tendon

  • Ratio SWV short axis/SWV long axis

  • *Measured at the base of the lateral epicondyle, perpendicular to tendon with transducer in long axis.

  • †Determined on a long axis image; degree of hypoechogenicity determined as % of tendon surface.

  • ‡Assessed on long axis image of the tendon.

  • ARFI, acoustic radiation force impulse; SWV, shear wave velocities.