Ultrasound of Ankle and Foot: Overuse and Sports Injuries

Abstract

Sports and overuse injuries of the ankle and foot are commonly encountered in clinical practice. Ultrasound (US) has been established as an excellent diagnostic modality for foot and ankle injuries, providing a rapid noninvasive, economical, and readily available tool that is well tolerated by the patient with acute or chronic pain. The opportunity for dynamic examination is another advantage of US in evaluating ankle and foot pathology, where maneuvers such as muscle contraction and stressing of the joint may be particularly helpful. In many cases, US can be used as a first-line and only imaging modality for diagnosis. This article focuses on ankle disorders related to sports or overuse that affect tendons, including tendinosis, tenosynovitis, paratendinitis, rupture, dislocation, and ligaments that are commonly torn. The sonographic features of certain common foot disorders related to physical activity and overuse are also discussed, including plantar fasciitis, Morton's neuroma, stress fractures, and plantar plate injury.

Allograft tendon reconstruction of the anterior talofibular ligament and calcaneofibular Ligament in the treatment of chronic ankle instability

“…Although MRI has become the preferred tool for evaluating tendons and ligaments [18], B-ultrasound is a uniquely powerful diagnostic tool, with the ability to intensively examine an pathological area during motion [19–22]. The commonly stated shortcoming of so-called operator dependence, on the other hand, becomes a distinct advantage over any of the other radiology tests, particularly in evaluation of the ligaments.…”

ACR Appropriateness Criteria Acute Trauma to the Foot

“…The sesamoids will not track distally with great toe extension at the metatarsalephalangeal joint on forced dorsiflexion lateral view or fluoroscopy [41]. Ultrasound in the sagittal plane best visualizes the plantar plate between the flexor tendon and hyaline cartilage of the metatarsal head [42]. Tears may be partial or complete and mainly involve the second toe, and less commonly, the third and fourth toes [42].…”

“…Ultrasound in the sagittal plane best visualizes the plantar plate between the flexor tendon and hyaline cartilage of the metatarsal head [42]. Tears may be partial or complete and mainly involve the second toe, and less commonly, the third and fourth toes [42]. Ultrasound has shown a 96% sensitivity, compared with 87% sensitivity of MRI, for detection of lesser toe plantar plate tears; however, both modalities have poor specificity [43].…”

Investigating persistent bilateral ankle swelling

“…US examination is frequently used in emergency room settings as its accuracy for the detection of chronic ankle ligament injuries is very high (sensitivity of 98.9% and specificity of 96.2%) [5]. The US assessment of hindfoot joints in patients with inflammatory arthritis of the ankle in the context of rheumatoid arthritis showed variable sensitivi-ty (64-89%) and specificity (60-80%) in a recent study [6].…”