Tendinosis, also referred to as tendinopathy, is a degenerative process with eosinophilic, fibrillar, and mucoid degeneration of the tendon (Jacobson 29).
Sonographically, tendinosis can be seen as a focal heterogeneous, relatively ill-defined hypoechoic area within the tendon. There will be no visible tendon defect and cortical irregularity is not usually associated with this proccess.
Diffuse tendinosis may cause the entire tendon to appear hypoechoic.
It is important to ensure the sound beam is interacting with the tendon at a perpendicular angle to avoid the artifact anisotropy. Anisotropy can mimic the ultrasound characteristics seen with tendinosis.