ABSTRACT
Ankle tendon and ligament disorders are commonly encountered in everyday orthopedic practice. Whereas tendons can be affected by traumatic, degenerative, and inflammatory conditions, ligaments are mostly involved by tears. Ultrasonography (US) has been accepted worldwide as an efficient, ready, dynamic, and noninvasive tool in assessing ankle tendons and ligaments. The recent technological advances in software and hardware of US equipment have improved the possibilities of US in ankle assessment, and modern equipment allows an accurate depiction of ankle structures. As with all imaging modalities, knowledge of the scanning technique and knowledge of normal US anatomy are prerequisites for a successful examination. In this article we briefly review the normal anatomy of ankle tendons and main ligaments relevant to the US examination. Then we present the routine US technique of examination for the anterior, posterolateral, posteromedial, and posterior region followed by a description of the normal US appearance of tendons, bursae, and ligaments.
KEYWORDS
Ultrasound - ankle - tendons
REFERENCES
-
1
Fessell D P, van Holsbeeck M T.
Foot and ankle sonography.
Radiol Clin North Am.
1999;
37
831-858
-
2
Patel S, Fessell D P, Jacobson J A, Hayes C W, van Holsbeeck M T.
Artifacts, anatomic variants and pitfalls in sonography of the foot and ankle.
AJR Am J Roentgenol.
2002;
178
1247-1254
-
3
Fessell D P, Vanderschueren G M, Jacobson J A et al..
US of the ankle: technique, anatomy, and diagnosis of pathologic conditions.
Radiographics.
1998;
18
325-340
-
4
Morvan G, Mathieu P, Busson J, Wybier M.
Ultrasonography of tendons and ligaments of foot and ankle.
J Radiol.
2000;
81
361-380
-
5
Martinoli C, Derchi L E, Pastorino C et al..
Analysis of echotexture of tendons with US.
Radiology.
1993;
186
839-843
-
6
Bianchi S, Zwass A, Abdelwahab I F et al..
Evaluation of tibialis anterior tendon rupture by ultrasonography.
J Clin Ultrasound.
1994;
22
564-566
-
7
Zeiss J, Saddemi S R, Ebraheim N A.
MR imaging of the peroneal tunnel.
J Comput Assist Tomogr.
1989;
13
840-844
-
8
Sobel M, Levy M E, Bohne W H.
Congenital variations of the peroneus quartus muscle: an anatomic study.
Foot Ankle.
1990;
11
81-88
-
9
Chepuri N B, Jacobson J A, Fessell D P et al..
Sonographic appearance of the peroneus quartus muscle: correlation with MR imaging appearance in seven patients.
Radiology.
2001;
218
415-419
-
10
Mick C A, Lynch F.
Reconstruction of the peroneal retinaculum using the peroneus quartus. A case report.
J Bone Joint Surg Am.
1987;
69
296-297
-
11
Hsu T C, Wang C L, Wang T G et al..
Ultrasonographic examination of the posterior tibial tendon.
Foot Ankle Int.
1997;
18
34-38
-
12
Martinoli C, Bianchi S, Gandolfo N et al..
US of nerve entrapments in osteofibrous tunnels.
Radiographics.
2000;
20 Spec No
S199-S217
-
13
Kouvalchouk J F, Fisher M.
Les muscles accessoires au niveau de la cheville.
Mise Au Point J Traumatol Sport.
1998;
15
101-106
-
14
Koivunen-Niemela T, Parkkola K.
Anatomy of the Achilles tendon (tendo calcaneus) with respect to tendon thickness measurements.
Surg Radiol Anat.
1995;
17
263-268
-
15
Bertolotto M, Perrone R, Martinoli C et al..
High resolution ultrasound anatomy of normal Achilles tendon.
Br J Radiol.
1995;
68
986-991
-
16
Fornage B D.
Achilles tendon: US examination.
Radiology.
1986;
159
759-764
-
17
Mathieson J R, Connell D G, Cooperberg P L et al..
Sonography of the Achilles tendon and adjacent bursae.
AJR Am J Roentgenol.
1988;
151
127-131
-
18
Brasseur J L, Luzzati A, Lazennec J Y et al..
Ultrasonoanatomy of the ankle ligaments.
Surg Radiol Anat.
1994;
16
87-91
-
19
Campbell D G, Menz A, Isaacs J.
Dynamic ankle ultrasonography. A new imaging technique for acute ankle ligament injuries.
Am J Sports Med.
1994;
22
855-858
-
20
Milz P, Milz S, Putz R et al..
13 MHz high-frequency sonography of the lateral ankle joint ligaments and the tibiofibular syndesmosis in anatomic specimens.
J Ultrasound Med.
1996;
15
277-284
-
21
Peetrons P, Silvestre A, Cohen M, Creteur V.
Ultrasonography of the ankle ligaments.
Can Assoc Radiol J.
2002;
53
6-13
Dr.
Stefano Bianchi
Fondation et Clinique des Grangettes, 7 chemin des Grangettes
1224 Chene-Bougeries, Switzerland
