Torsional injury to the ankle resulting in fibular neuropathy affects the common fibular nerve as well as its terminal branches, specifically, the articular branch (original) (raw)
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The anatomy of the nerves of the foot and ankle is complex, and familiarity with the normal anatomy and course of these nerves as well as common anatomic variants is essential for correct identification at imaging. Ultrasonography (US) and magnetic resonance (MR) imaging allow visualization of these nerves and may facilitate diagnosis of various compression syndromes, such as " jogger's heel, " Baxter neuropathy, and Morton neuroma. It may be difficult to distinguish the nerves from adjacent vasculature at MR imaging , and US can help in differentiation. The authors review the normal anatomy and common variants of the nerves of the foot and ankle, with use of dissected specimens and correlative US and MR imaging findings. In addition, the authors illustrate proper probe positioning, which is essential for visualizing the nerves at US. The authors' discussion focuses on the superficial and deep peroneal, sural, saphenous, tibial, medial and lateral plantar, me-dial and inferior calcaneal, common digital, and medial proper plantar digital nerves.
Magnetic resonance imaging of injuries to the ankle joint: can it predict clinical outcome?
Skeletal Radiology, 1997
Objective. To predict clinical outcome after ankle sprains on the basis of magnetic resonance (MR) findings. Design and patients. Twenty-nine consecutive patients (mean age 32.9 years, range 13-60 years) were examined clinically and with MR imaging both after trauma and following standardized conservative therapy. Various MR abnormalities were related to a clinical outcome score. Results. There was a tendency for a better clinical outcome in partial, rather than complete, tears of the anterior talofibular ligament and when there was no fluid within the peroneal tendon sheath at the initial MR examination (P=0.092 for either abnormality). A number of other MR features did not significantly influence clinical outcome, including the presence of a calcaneofibular ligament lesion and a bone bruise of the talar dome. Conclusion. Clinical outcome after ankle sprain cannot consistently be predicted by MR imaging, although MR imaging may be more accurate when the anterior talofibular ligament is only partially torn and there are no signs of injury to the peroneal tendon sheath.
Skeletal Radiology, 2008
The purpose of this article is to highlight the anatomical variants, technical pitfalls, and the prevalence of abnormal conditions in the asymptomatic population in magnetic resonance imaging of the foot and ankle. Special attention is drawn to the complex anatomy of the deltoid ligament (the superficial tibionavicular ligament, tibiospring ligament, the tibiocalcaneal ligament, and the deep anterior and posterior tibiotalar ligaments) and the posterior tibial tendon insertion including the magic angle artifact and the high prevalence of asymptomatic findings such as "hypertrophied" peroneal tubercle (abnormal only when larger than 5 mm), peroneus quartus (prevalence 17%), and cysts (vascular remnants) just inferior to the angle of Gissane.
Role of Magnetic Resonance Imaging in Evaluation of Traumatic Ankle Injuries
Background: Ankle trauma is commonly encountered and is most often a sprain injury affecting the ligaments. Accurate diagnosis and appropriate treatment rest on knowledge of complex ligamentous anatomy of ankle and the entire spectrum of pathologies. Magnetic resonance imaging (MRI) is the imaging modality of choice for diagnosing ligament pathologies because of its multiplanar capability and high soft tissue contrast. With MRI, it is possible to triage and attribute the cause of post traumatic ankle pain to bone, ligament, or tendon pathologies, which otherwise overlap clinically. Materials and Methods: Fifty patients with clinical suspicion of traumatic ankle injuries referred to the Department of Radio-Diagnosis from November 2018 to May 2020 underwent MRI of ankle. The main source of data for the study were patients from Victoria Hospital, Bowring and Lady Curzon Hospital and Vani Vilas hospital attached to Bangalore Medical College and Research Institute, Bengaluru. All MR imaging examinations were performed on a Siemens 1.5-T MagnetomAvanto MR system. Protocol of MRI ankle used in the study: Axial T1W / TSE, Axial T2W / TSE, Axial-STIR / TSE, Sagittal T2W / TSE, Sagittal STIR / TSE, Coronal T1W / TSE, Coronal T2W / TSE, Coronal STIR / TSE images were obtained in all the patients. Results: Among the 50 patients, 28% of the cases were found to be normal and 72% had findings. Ankle joint effusion (50%) was the most common finding seen, followed by ligament injuries (38%) tendon injuries (20%) and osseous injuries (20%). ATFL (45%) was the most commonly injured ligament followed by PTFL (17%) and deltoid ligament (14%) injuries. Sprain (53%) was the most common type of ATFL injury followed by complete tear (26%) and partial tear (21%). Tibionavicular (21%) and tibiocalcaneal (21%) were the most common ligaments injured in deltoid ligament. FHL (30%) and tibilalis posterior (30%) were the most common tendons injured. Bone contusion was the most common osseous injury (61%) followed by fractures (31%) and joint dislocation (8%). Conclusion: MRI was found to be a key modality to evaluate various soft tissue injuries of the ankle and to arrive at an accurate diagnosis. Characterization of the lesions and awareness of the common pathologies will help the clinician arrive at an informed differential diagnosis. MRI is a non-invasive imaging modality with no radiation hazard, excellent resolution and multiplanar imaging capability. Use of prompt imaging will be helpful to accurately diagnose the soft tissue injuries of the ankle.
Magnetic resonance imaging (MRI) of the ankle and hindfoot
Acta orthopaedica Belgica, 1992
While Magnetic Resonance Imaging (MRI) has become a routine diagnostic method to deal with pathology of the knee, little has been published about foot and ankle lesions. This is probably due to the anatomic complexity of bone and ligamentous structures of these small joints, necessitating the use of very thin slices from various orientation planes (orthogonal and oblique planes). A special technique is needed allowing a 3-dimensional (3D) analysis, using inframillimetric slices and more sophisticated equipment than for 2-dimensional (2D) MRI (high fields with good homogeneity, specialized image processors...). An initial potential indication of the method is the precise diagnosis of lateral ligamentous components in severe sprains. MRI may determine if surgical therapy is needed. The ligamentous components are reconstructed along their specific planes thanks to the 3D method. Furthermore, assessment of the ligamentous damage is also possible in chronic ankle instability (elongation,...
MR Imaging of the Ankle and Foot
RadioGraphics, 2000
Magnetic resonance (MR) imaging has opened new horizons in the diagnosis and treatment of many musculoskeletal diseases of the ankle and foot. It demonstrates abnormalities in the bones and soft tissues before they become evident at other imaging modalities. The exquisite soft-tissue contrast resolution, noninvasive nature, and multiplanar capabilities of MR imaging make it especially valuable for the detection and assessment of a variety of soft-tissue disorders of the ligaments (eg, sprain), tendons (tendinosis, peritendinosis, tenosynovitis, entrapment, rupture, dislocation), and other soft-tissue structures (eg, anterolateral impingement syndrome, sinus tarsi syndrome, compressive neuropathies [eg, tarsal tunnel syndrome, Morton neuroma], synovial disorders). MR imaging has also been shown to be highly sensitive in the detection and staging of a number of musculoskeletal infections including cellulitis, soft-tissue abscesses, and osteomyelitis. In addition, MR imaging is excellent for the early detection and assessment of a number of osseous abnormalities such as bone contusions, stress and insufficiency fractures, osteochondral fractures, osteonecrosis, and transient bone marrow edema. MR imaging is increasingly being recognized as the modality of choice for assessment of pathologic conditions of the ankle and foot.
MR imaging of ankle impingement lesions
Magnetic resonance imaging clinics of North America, 2009
Impingement is defined as a painful limitation of motion. Impingement lesions as identified on MR imaging of the ankle may relate to a range of soft tissue or bony pathologies that can be interpreted as predisposing to painful limitation of motion, accepting that the diagnosis of impingement remains clinical and not radiological. Typically, impingement lesions are classified according to their location and whether the underlying pathology is osseous or soft tissue in nature. Most commonly, impingement lesions relate to posttraumatic synovitis and intra-articular fibrous bands-scar tissue, capsular scarring, or bony prominences, the latter either developmental or acquired. Well-recognized sites of impingement around the ankle include the anterolateral, centroanterior, anteromedial, posteromedial, and posterior sites. This article reviews the anatomy in these regions and focuses on common causes of impingement around the ankle; their pathogenesis, clinical features, and management; th...