Background: This study aims to evaluate the value of adding elastography (strain elastography) to US in the evaluation of tendon abnormalities with comparison to conventional MRI. Methodology: After institutional review board approval and informed consent taken from all the patients, supraspinatus and tendoachillis tendon sonoelastography performed on 46 patients with shoulder or ankle pain and limitation of movement. Statistical analysis of this research was assessed by Chi-square test, Fisher’s exact test and Independent-Samples t-test. Results: This study included 46 patients with shoulder or ankle pain and limitation of movement, 23 male and 23 female patients. Their mean age (years) ± SD was 51.30 ± 12.4 years. We found that US had perfect agreement with MRI for detection of complete tear (k=1), strong agreement in diagnosis of partial tendon tear (k=0.810), while moderate agreement in detection of tendinopathy (k=0.645). Also we found that elastography increased US sensitivity and accuracy in diagnosis of partial tendon tear from (73.3% and 93.9% to 86.7% and 97% respectively) while it didn’t add any effect to US in diagnosis of complete tendon tear. Conclusion: Elastography plays an important role if added to US in evaluation of tendon abnormalities, especially if MRI is contraindicated for any reason.
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