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Introduction The use of ultrasound images for analyzing muscle quality and size is continuing to grow in the literature. However, many of these manuscripts fail to properly describe their measurement techniques and steps involved in analyzing ultrasound images. Aim of this study To evaluate the intra- and inter-rater reliability of the steps involved when analyzing ultrasound images to measure cross-sectional area and echo intensity. Material and methods Twenty ultrasound images of the rectus femoris and vastus lateralis images were blinded and replicated,