Rectus femoris muscle overload: what do we expect to find in ultrasound? Rectus femoris muscle injuries are very common in sports activities, and ultrasound is a highly sensitive tool for diagnosing them. Based on the ultrasound criteria described in the previous publication, both in static images and in dynamic studies, to diagnose rectus femoris muscle overload, the following must be observed: A) Static ultrasound: A1.- In the axial image, an increase in “tension” of the indirect tendon is observed, characterized by an almost perpendicular orientation instead of its normal coma morphology. A2.- In the longitudinal plane, the pennation angle increases compared to the contralateral muscle without alteration of the typical fibrillar pattern. B) Dynamic ultrasound: B1.- A lesser muscle deformity is seen on sonocompression with the transducer associated with a greater muscle tone on “sonopalpation”. B2.- There is little muscle mobility during isometric contraction, significantly less than the opposite side and with minimal increase in its anteroposterior diameter.

Trigger finger: ultrasound diagnosis and treatment Patient with stiffness in the first finger of the right hand, especially in the morning, which is accompanied by a sensation of clicking or crunching when moving the finger, associated with sensitivity and a lump in the palm at the level of the metacarpophalangeal joint. An ultrasound study shows a diffuse increase in the thickness of the flexor tendon, observing the tendon snapping at the level of pulley A1 in a dynamic study when the tendon slides. Initially, infiltration of 1 cc of trigon and 1 cc of 2% mepivacaine into the tendon sheath is performed under ultrasound control to subsequently proceed to fenestration of the pulley until the tendon is released. Sometimes, it can be associated with physiotherapy to unload the muscles in the forearm, performing proximal peritendinous infiltration of the first finger's extensor muscle to prevent the pathology's recurrence.