Anechoic areas are regions without internal echoes (echo free). Cysts or fluid filled regions are anechoic and may demonstrate enhanced echoes posterior to the fluid.

Anatomic structures respond with characteristic features on ultrasound scanning.
There are some ultrasound terms, referring to the echo appearance, that describes tissue appearance in a uniform manner:

Tendons characteristically are hyperechoic on ultrasound because of the fibrillar pattern. Ligaments appear hyperechoic when the beam is perpendicular to the tissue. Peripheral nerves are hyperechoic relative to muscle.
Muscle appears relatively hypoechoic to tendon fibers. Close observation reveals hypoechoic muscle fibers separated by hyperechoic septae that converge on a hyperechoic aponeurosis. Articular hyaline cartilage appears hypoechoic. The presence of fluid within the joint outlining the cartilage produces a thin bright echo at this interface.
Sound beams do not penetrate the bone cortex. The very bright echo produced at the interface allows both recognition of the bone cortex but also can demonstrate fracture, spurring and bone callus bridging. Abnormal soft tissue calcification and ossification also produces bright reflective echoes.
Cysts or fluid filled areas are without internal echoes and are called echo free or anechoic and may demonstrate enhanced soft tissue echoes posterior to the fluid collection. Inflamed metatarsal bursae and calcaneal bursae clearly depict fluid swelling.

See also Beam Pattern and Zero Offset.

A thyroid ultrasound evaluates the size and shape of the thyroid gland and parathyroid glands. A thyroid ultrasound can show nodules, cysts, tumors, and an enlargement, but a sonogram cannot determine the function of the thyroid. Ultrasound guides the placement of the needle during a thyroid fine needle aspiration biopsy.

See also Sonographic Features, Ultrasound Imaging Modes, Anechoic, Beam Width Artifact and Enhancement Artifact.

An ultrasound (US) scanning gel has the same conductivity as the human body and is applied between the transducer and the skin surface. Air is a bad conductor of US, so this acoustic gel is used to conducts the sound beam and allows the ultrasound probe to pass smoothly over the skin.
The gel will be removed after the examination, and it will not stain skin or clothing. The basic dermatological requirement of a scanning gel is that it be free of skin irritants or sensitizers. In addition, effective preservatives with low incidence of skin reaction are required to prevent microbiological degradation of the gel. The broad range of patients imaged with ultrasound, from pregnant women and infants to the infirm or elderly dictates that the risk of skin reaction must be minimized.
The effect of small bubbles in the ultrasound couplant under the transducer is to disperse the ultrasound which results in clouding of the image. This effect is most clearly seen on anechoic regions of the image which becomes cloudy. Air bubbles, regardless of their size, degrade the performance of ultrasound in all medical applications including imaging, Lithotripsy and physical therapy.
There are some chemicals, including mineral oil, silicone oil, alcohol, surfactants, and fragrances that can degrade the acoustic lens, destroy bonding, or change the acoustic properties of the lens. The use of scanning gels or lotions in diagnostic ultrasound containing these chemicals should be avoided. In therapeutic ultrasound, ultrasound transmission gels and lotions commonly contain oils and other chemicals not intended for use with diagnostic imaging transducers.

See also Ultrasound Therapy and Ultrasound Physics.