Use of Ultrasonography for Foot and Ankle Sports Injuries

Moon Youngseok; Kim Chong-bin; Hoon Ahn Jae

doi:10.4055/jkoa.2019.54.5.402

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Youngseok, Chong-bin, and Jae: Use of Ultrasonography for Foot and Ankle Sports Injuries

Original Article

J Korean Orthop Assoc 2019;54(5):402-410.

DOI: https://doi.org/10.4055/jkoa.2019.54.5.402

Use of Ultrasonography for Foot and Ankle Sports Injuries

Moon Youngseok, M.D., Kim Chong-bin, M.D., Hoon Ahn Jae, M.D.

Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to: Jae Hoon Ahn, M.D. Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea TEL: +82-2-2258-2837 FAX: +82-2-535-9834 E-mail: jahn@catholic.ac.kr ORCID: https://orcid.org/0000-0002-4253-3943

Received 16 May 201824 August 2018 Accepted 14 October 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sports injuries of the foot and ankle are commonly encountered in clinical practice. Ultrasound is very useful for the diagnosis of such injuries, because it is more economical, readily accessible, and can perform a dynamic study compared to magnetic resonance imaging. This review focused on the sonographic features of common foot and ankle sports injuries.

Keywords: foot, ankle, sports injury, ultrasound

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Figure 1.

Ultrasonography images showing the sprained ankle ligaments. (A) An ultrasonography image shows a small defect (arrow) in the middle portion of the swollen anterior talofibular ligament, which is consistent with a mild to moderate sprain. (B) This ultrasonography image clearly shows a complete rupture of the anterior talofibular ligament. (C) Ultrasonography of the anterior talofibular ligament was performed in ankle plantar flexion and slight inversion, in which position the ligament was tensioned. (D) On the other hand, ultrasonography of the calcaneofibular ligament was performed in ankle dorsiflexion and slight inversion. (E) Calcaneofibular ligament (arrow) is well visualized in ankle dorsiflexion and slight inversion. Moderate effusion is observed around the calcaneofibular ligament on this image. (F) The integrity of anterior inferior tibiofibular ligament (arrow) can be confirmed by ultrasonography, when a syndesmosis injury is suspected. LM, lateral malleolus; Calc, calcaneus; TIB, tibia; FIB, fibula.

Figure 2.

(A) Long-axis ultrasonography image shows moderate swelling of the plantar fascia in the calcaneal insertion site. (B) The thickness of the plantar fascia is more than 8 mm in the left image, while that of the other side is less than 4 mm. Calc, calcaneus.

Figure 3.

(A) Photograph of the right foot shows a bruise along the plantar fascia. (B) An ultrasonography image shows a partial interruption of the plantar fascia (arrow) near the calcaneal insertion. (C) T2-weighted fat suppression magnetic resonance imaging confirms the partial rupture of the plantar fascia (arrow). Calc, calcaneus.

Figure 4.

(A) Anteroposterior radiograph of the left foot shows medial subluxation of the 2nd metatarsophalangeal (MTP) joint. (B) An ultrasonography images show the tear of the lateral part of the plantar plate (arrow) in the 2nd MTP joint. 2: the 2nd metatarsal head, 3: the 3rd metatarsal head.

Figure 5.

Long-axis ultrasonography image shows complete rupture and gap formation of the Achilles tendon.

Figure 6.

(A) Photograph shows a bruise in the proximal part of left calf. (B) The extended field of view ultrasonography image shows a hematoma (arrow) in the junction of the medial GC and the Sol, which is consistent with a ‘tennis leg’ injury. GC, gastrocnemius muscle; Sol, soleus muscle.

Figure 7.

(A) Ultrasonography of peroneal tendon was performed in lateral decubitus position with hip and knee flexion. (B) A long-axis ultrasonography image shows a partial tear (arrow) of the peroneus brevis tendon. LM, lateral malleolus.

Figure 8.

Short-axis ultrasonography images of the retromalleolar area show the normal (A) and the dislocated (B) peroneal tendons. LM, lateral malleolus; PL, peroneus longus tendon; PB, peroneus brevis tendon.

Figure 9.

Short-axis dynamic ultrasonography image shows the instability of the peroneus brevis tendon within the peroneal sheath. The patient was requested to do active eversion of the ankle joint while undergoing the ultrasonography. PB; peroneus brevis tendon; PL, peroneus longus tendon; LM, lateral malleolus.

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