Background The knee joint is one of the most commonly injured joints in the body. Because of its complex structure, the joint is subjected to numerous pathologies and due to the recent increase in various sport activities; there has been a parallel increase in sport-induced internal derangements of the knee. Ultrasound is emerging as a viable imaging modality in the assessment of the musculoskeletal system lesions especially in experienced hands Objective To evaluate the role of high resolution dynamic ultrasonography as a diagnostic tool in the assessment of different causes of knee joint pain compared to MR imaging. Patients and Methods This study included 50 patients with painful knee joints as 32 females and 18 males, 16 patients had bilateral knee examination. Their ages ranged between 5-66 years. The cases was referred to a private radiological center, some of them referred to assess the knee joint pain by ultrasound as a fast and cheapest modality, yet most of the cases referred to evaluate the knee joint by MRI and the ultrasound was done as complementary study. Results Comparing between ultrasound and MRI in evaluation of painful knee joints, although the ultrasound has role in evaluation of bursal, synovial and peri-articular soft tissue lesions, the MRI is advised as a primary imaging tool for cruciates, meniscal and ligamentous lesions when clinically suspected. Conclusion Ultrasonography is a safe, cheap and efficient tool in the evaluation of the peri articular soft tissues with limited screening role at the internal knee joint cruciate / meniscal derangements as well as some bony lesions involving the bony cortex. It has no role in the intramedullary bony lesions. At this point, we concluded that ultrasonography has an important complementary role with MRI examination in the evaluation of the knee pain of different causes yet it is operator dependent and needs experience.
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