Sonographic anatomy of the ankle

Precerutti, M.; Bonardi, Mara; Ferrozzi, G; Draghi, Ferdinando

doi:10.1007/s40477-013-0025-x

Cited by 34 publications

(31 citation statements)

References 9 publications

(19 reference statements)

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“…On ultrasound, similarly to ligaments, PF shows a fibrillar pattern due to the hyperechoic appearance of type I collagen fibre bundles embedded within a background of hypoechoic matrix [45, 46]. …”

Section: Ultrasoundmentioning

confidence: 99%

Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging

et al. 2016

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Plantar fascia (PF) disorders commonly cause heel pain and disability in the general population. Imaging is often required to confirm diagnosis. This review article aims to provide simple and systematic guidelines for imaging assessment of PF disease, focussing on key findings detectable on plain radiography, ultrasound and magnetic resonance imaging (MRI). Sonographic characteristics of plantar fasciitis include PF thickening, loss of fibrillar structure, perifascial collections, calcifications and hyperaemia on Doppler imaging. Thickening and signal changes in the PF as well as oedema of adjacent soft tissues and bone marrow can be assessed on MRI. Radiographic findings of plantar fasciitis include PF thickening, cortical irregularities and abnormalities in the fat pad located deep below the PF. Plantar fibromatosis appears as well-demarcated, nodular thickenings that are iso-hypoechoic on ultrasound and show low-signal intensity on MRI. PF tears present with partial or complete fibre interruption on both ultrasound and MRI. Imaging description of further PF disorders, including xanthoma, diabetic fascial disease, foreign-body reactions and plantar infections, is detailed in the main text. Ultrasound and MRI should be considered as first- and second-line modalities for assessment of PF disorders, respectively. Indirect findings of PF disease can be ruled out on plain radiography. Teaching Points • PF disorders commonly cause heel pain and disability in the general population.• Imaging is often required to confirm diagnosis or reveal concomitant injuries.• Ultrasound and MRI respectively represent the first- and second-line modalities for diagnosis.• Indirect findings of PF disease can be ruled out on plain radiography.

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Section: Ultrasoundmentioning

confidence: 99%

Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging

et al. 2016

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“…Superior extensor retinaculum: The transducer was placed at the anterior ankle joint in the transverse plane, at the level of the insertion on the medial aspect of distal tibia, superficial to the tibialis anterior tendon. The anteroposterior thickness was evaluated …”

Section: Anterior Compartment Of the Ankle: Patient Was Seated On Thementioning

confidence: 99%

“…Superior peroneal retinacula: The probe was placed behind the lateral aspect of the fibula, superficial to the short axis of the peroneus longus tendon. The anteroposterior thickness was evaluated …”

Section: Lateral Compartment Of the Ankle: The Patient Was Seated On mentioning

confidence: 99%

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Ankle and Foot Ultrasound: Reliability of Side‐to‐Side Comparison of Small Anatomic Structures

Rossi

Picasso

Martinoli

et al. 2018

J of Ultrasound Medicine

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Objectives In sonography of clinically relevant small structures of the ankle and foot, the healthy contralateral side can be used as a reference to identify subtle abnormalities. Intrasubject side‐to‐side variability must be minimal. The aim of this study was to assess the reliability of side‐to‐side sonographic evaluation of small structures of the ankle and foot. Methods Thirty healthy volunteers were prospectively studied. Small structures of the ankle and foot were evaluated bilaterally by 2 musculoskeletal radiologists in separate sessions. The deep peroneal nerve, superior extensor retinacula, calcaneofibular ligament, superior peroneal retinacula, tibialis posterior tendon, tibial nerve, Achilles tendon, plantaris tendon, plantar fascia, and sural nerve were considered. To assess intra‐ and interreader agreements, 30 (100%) examinations were repeated. A nonparametric statistic was used. Results Data were not normally distributed (P > .001). Intrareader agreement was k = 0.67 (95% confidence interval, 0.57–0.78) and interreader agreement was k = 0.73 (95% confidence interval, 0.68–0.77). The mean values and standard deviation for all the structures were 0.36 ± 1.85 mm. The overall coefficient of variation was 18.5%. The intraclass correlation coefficient was 0.93 (95% confidence interval, 0.92–0.94). Conclusions In ankle and foot sonography, the healthy contralateral side can be used as a reference during a real‐time musculoskeletal ultrasound evaluation of small structures.

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“…For completeness' sake, it is important to recall that the talocrural joint complex is also stabilized by extrinsic ligaments-the calcaneofibular ligament, the posterior talofibular ligament, and the deltoid ligament-which are easy to study with other imaging methods [3,4,[11][12][13][14] and are not included in the present study. US examination of the ST is complicated by the amount of adipose tissue within the sinus and by the depth and orientation of some of the intrinsic ligaments.…”

Section: Introductionmentioning

confidence: 99%

Sonographic visibility of the sinus tarsi with a 12 MHz transducer

Stella¹,

Ciampi²,

Orsitto

et al. 2014

J Ultrasound

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Objectives To assess the value of ultrasonography in studies of the ligaments within the sinus tarsi (ST) in healthy subjects. Materials and methods We examined 20 healthy volunteers using a 12-MHz transducer with THI and compound imaging. With the foot in inversion, the following structures were examined with coronal and transverse scans: (1) the root of the inferior extensor retinaculum (RIER); (2) the interosseous talocalcaneal ligament (ITCL); (3) the cervical ligament (CL); (4) the bifurcate ligament (BL); (5) the synovial recesses, which were examined for possible distention (distended synovial recesses, DSR). The sonographic features, orientation, and thickness of each ligament were assessed. Results The easiest structure to identify (visualized in 20/20 subjects) was the RIER, which formed a semiarch. The two deeper layers were hypoechoic, the superficial layer hyperechoic. The ITCL was situated posteriorly and deep with an oblique course. It appeared hypoechoic with a mean thickness of 4.06 mm ± 0.7. It was visualized in 18/20 (90 %) subjects. The CL (isoechoic/hyperechoic) was located more anteriorly at an intermediate depth. The orientation was almost vertical. It was visualized in 17/20 (85 %) subjects, with a mean thickness of 2.28 mm ± 0.34. The BL appeared hypoechoic. It was visualized in 19/20 (95 %) subjects with transverse (anterior end of the ST) and longitudinal scans. The calcaneonavicular and calcaneocuboid components displayed mean (SD) thicknesses of 2.09 mm ± 0.37 and 2.7 mm ± 0.32, respectively. The ITCL and RIER were visualized in the same scan as a semiarch. DSR was observed in 4/20 (20 %) subjects. Conclusions The present study shows that, in patients with suspected ST pathology, the anatomic structures that make up this recess can be adequately examined with ultrasonography performed with ordinary 12-MHz transducers.Keywords Musculoskeletal ultrasound Á Sinus tarsi Á Harmonic imaging Á Compound imaging Sommario Obiettivi indagare la capacità degli ultrasuoni (US) di identificare le strutture legamentose del seno del tarso (ST) in un gruppo di soggetti sani. Materiali e Metodi abbiamo studiato 20 volontari sani, utilizzando sonde da 12 MHz, Compound e THI attivati. Sono stati indagati con piede in inversione: (1) 123J Ultrasound (2016) 19:107-113 DOI 10.1007/s40477-014-0145-y retinacolo inferiore degli estensori (RIER) (2) legamento interosseo (ITCL) (3) legamento cervicale (CL) (4) legamento biforcato (BL) (5) eventuali distensioni di recessi sinoviali (DSR), con scansioni coronali e trasversali, valutando ecostruttura, orientamento e spessore dei legamenti. Risultati (1) la RIER, repere ecografico, è stata la struttura di più agevole identificazione: con decorso a semiarco, ipoecogena nei 2 strati profondi, iperecogena in quello superficiale, visualizzata in 20/20 soggetti (2) il ITCL in situazione posteriore e profonda, con andamento obliquo ha presentato spessore medio di 4.06 mm ± 0.7, ipoecogeno, visualizzato in 18/20 (90 %); (3) il CL, più anteriore e orientamento qua...

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Sonographic anatomy of the ankle

Cited by 34 publications

References 9 publications

Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging

Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging

Ankle and Foot Ultrasound: Reliability of Side‐to‐Side Comparison of Small Anatomic Structures

Sonographic visibility of the sinus tarsi with a 12 MHz transducer

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