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Journal of Ultrasound

, Volume 17, Issue 2, pp 79–87 | Cite as

Sonographic anatomy of the ankle

  • M. PreceruttiEmail author
  • M. Bonardi
  • G. Ferrozzi
  • F. Draghi
Pictorial Essay

Abstract

Ankle sonography is one of the most commonly ordered examinations in the field of osteoarticular imaging, and it requires intimate knowledge of the anatomic structures that make up the joint. For practical purposes, the examination can be divided into four compartments, which are analyzed in this pictorial essay: the anterior compartment, which includes the tibialis anterior, extensor hallucis longus, and extensor digitorum longus tendons; the accessory peroneus tertius tendon; and the extensor retinaculum; the medial compartment (tibialis posterior, flexor digitorum longus, and flexor hallucis longus tendons; the flexor retinaculum; the medial collateral—or deltoid—ligament, and the neurovascular bundle); the lateral compartment (peroneus longus, peroneus brevis, and peroneus quartus tendons; superior and inferior peroneal retinacula, lateral collateral ligament); and the posterior compartment (Achilles tendon, plantaris tendon, Kagar’s triangle, superficial, and deep retrocalcaneal bursae). Scanning techniques are briefly described to ensure optimal visualization of the various anatomic structures.

Keywords

Ultrasonography Ankle Achilles tendon Flexor tendons of the foot Extensor tendons of the foot Ligaments of the ankle 

Riassunto

L’esame ecografico della caviglia è tra gli esami più richiesti nell’ambito dell’ecografia osteoarticolare; ne deriva la necessità di una conoscenza approfondita delle strutture anatomiche che la compongono. L’approccio ecografico per lo studio della caviglia è, per scopi pratici, organizzato per comparti; si analizzano nel presente pictorial essay le strutture del comparto anteriore (tendine tibiale anteriore, tendine estensore lungo dell’alluce, tendine estensore lungo delle dita, tendine peroneo tertius, retinacolo degli estensori), del comparto mediale (tendine tibiale posteriore, tendine flessore lungo delle dita, tendine flessore lungo dell’alluce, retinacolo dei flessori, legamento collaterale mediale o deltoideo, fascio vascolo-nervoso), del comparto esterno (tendini peronei breve e lungo, tendine peroneo quarto, retinacolo superiore ed inferiore dei peronei, legamento collaterale esterno), del comparto posteriore (tendine d’Achille, tendine del muscolo plantare, triangolo di Kager, borse sinoviali calcaneali superficiale e profonda). Si riporta inoltre qualche breve cenno di tecnica ecografica necessaria per l’ottimale visualizzazione delle strutture descritte.

Notes

Conflict of interest

Matteo Precerutti, Mara Bonardi, Guja Ferrozzi, Ferdinando Draghi declare that they have no conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Human and Animal Studies

This article does not contain any studies with human or animal subjects performed by the any of the authors.

References

  1. 1.
    Bianchi S, Martinoli C, Gaignot C, De Gautard R, Meyer JM (2005) Ultrasound of the ankle: anatomy of the tendons, bursae, and ligaments. Semin Musculoskelet Radiol 9(3):243–259CrossRefGoogle Scholar
  2. 2.
    Morvan G, Busson J, Wybier M, Mathieu P (2001) Ultrasound of the ankle. Eur J Ultrasound 14(1):73–82CrossRefGoogle Scholar
  3. 3.
    Draghi F, Precerutti M, Gervasio A, Spinazzola A, Madonna L, Ferrozzi G (2006) Caviglia e piede. In: Busilacchi P, Rapaccini GL (eds) Ecografia clinica Cap 33. Idelson–Gnocchi, Italy, pp 575–584Google Scholar
  4. 4.
    Bianchi S, Martinoli C (2007) Ultrasound of the musculoskeletal system. Springer, Berlin, p 774Google Scholar
  5. 5.
    Bianchi S, Zwass A, Abdelwahab IF, Zoccola C (1994) Evaluation of tibialis anterior tendon rupture by ultrasonography. J Clin Ultrasound 22(9):564–566CrossRefGoogle Scholar
  6. 6.
    Jon Thompson C (2003) Atlante di anatomia ortopedica di Netter. Masson, p 243–280Google Scholar
  7. 7.
    Lhoste-Trouilloud A (2012) The tibialis posterior tendon. J Ultrasound 15(1):2–6CrossRefGoogle Scholar
  8. 8.
    Pallardy G, Chevrot A (1989) Artrografia opaca. Masson, Italy, p 108Google Scholar
  9. 9.
    O’Neill J (2008) Musculoskeletal ultrasound: anatomy and technique. Cap. 11. Springer, New YorkCrossRefGoogle Scholar
  10. 10.
    Kouvalchouk JF, Fisher M (1998) Les muscles accessoires au niveau de la cheville. Mise au point. J Traumatol Sport 15:101–106Google Scholar
  11. 11.
    Draghi F, Abbati D, Azzaretti A, Berton F, Braschi M, Calliada F, Coscia D, Ferrozzi G, Gervasio A, La Fianza A, Madonia L, Pagani C, Precerutti M, Spinazzola A, Vercelli A (2004) Ecografia della Caviglia. Idelson, Gnocchi, pp 13–30Google Scholar
  12. 12.
    Danowsky RG, Chanussot JC (2000) Traumatologia dello sport. Masson 2000:176–210Google Scholar
  13. 13.
    Sobel M, Levy MP, Bohne WH (1990) Congenital variations of the peroneus quartus muscle; an anatomic study. Foot ankle 11:81–88CrossRefGoogle Scholar
  14. 14.
    Maffulli N, Sharma P, Luscombe KL (2004) Achilles tendinopathy: aetiology and management. J R Soc Med 97(10):472–476CrossRefGoogle Scholar
  15. 15.
    Louis LJ (2008) Musculoskeletal Ultrasound intervention: principles and advances. Radiol Clin North Am 46:515–533CrossRefGoogle Scholar

Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2013

Authors and Affiliations

  • M. Precerutti
    • 1
    Email author
  • M. Bonardi
    • 2
  • G. Ferrozzi
    • 3
  • F. Draghi
    • 4
  1. 1.AO Provincia di PaviaOspedale Civile di VogheraVogheraItaly
  2. 2.Fondazione IRCCS, Policlinico San Matteo di Pavia, UO RadiodiagnosticaPaviaItaly
  3. 3.Dipartimento di RadiologiaOspedale Guglielmo da SalicetoPiacenzaItaly
  4. 4.Istituto di Radiologia, Policlinico San MatteoUniversità di PaviaPaviaItaly

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