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Tendons Around the Ankle

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Ultrasonography of the Lower Extremity
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Abstract

The tendons of the ankle may be divided into four compartments: anterior, medial, posterior, and lateral. The anterior compartment includes the tibialis anterior, extensor hallucis longus, and extensor digitorum longus tendons; an accessory peroneus tertius tendon may also be present. The medial compartment includes the tibialis posterior, flexor digitorum longus and flexor hallucis longus tendons; the posterior compartment, the Achilles and plantaris tendons; and the lateral compartment, the peroneus longus and the peroneus brevis tendons; a peroneus quartus tendon may also be present. Tendinopathy is easily diagnosed with ultrasound, and ultrasonographic-guided therapeutic procedures seem to be the most effective therapy in the same tendinopathy. Dynamic ultrasound is then the modality of choice for evaluation of tendon instability.

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References

  1. Bianchi S, Martinoli C, Gaignot C, De Gautard R, Meyer JM. Ultrasound of the ankle: anatomy of the tendons, bursae, and ligaments. Semin Musculoskelet Radiol. 2005;9(3):243–59.

    Article  Google Scholar 

  2. Precerutti M, Bonardi M, Ferrozzi G, Draghi F. Sonographic anatomy of the ankle. J Ultrasound. 2013;17(2):79–87.

    Article  Google Scholar 

  3. Morvan G, Busson J, Wybier M, Mathieu P. Ultrasound of the ankle. Eur J Ultrasound. 2001;14(1):73–82.

    Article  CAS  Google Scholar 

  4. Cheung Y, Rosenberg ZS, Magee T, Chinitz L. Normal anatomy and pathologic conditions of ankle tendons: current imaging techniques. Radiographics. 1992;12(3):429–44.

    Article  CAS  Google Scholar 

  5. Bianchi S, Martinoli C. Ultrasound of the musculoskeletal system. Berlin: Springer; 2007. p. 45–96.

    Book  Google Scholar 

  6. Martinoli C, Bianchi S, Dahmane M, Pugliese F, Bianchi-Zamorani MP, Valle M. Ultrasound of tendons and nerves. Eur Radiol. 2002;12(1):44–55.

    Article  Google Scholar 

  7. Hodgson RJ, O’Connor PJ, Grainger AJ. Tendon and ligament imaging. Br J Radiol. 2012;85:1157–72.

    Article  CAS  Google Scholar 

  8. Brenner E. Insertion of the tendon of the tibialis anterior muscle in feet with and without hallux valgus. Clin Anat. 2002;15(3):217–23.

    Article  Google Scholar 

  9. Musial WW. Variations of the terminal insertions of the anterior and posterior tibial muscles in man. Folia Morphol (Warsz). 1963;26(22):237–47.

    Google Scholar 

  10. Scheller AD, Kasser JR, Quigley TB. Tendon injuries about the ankle. Orthop Clin N Am. 1980;11(4):801–11.

    CAS  Google Scholar 

  11. Willegger M, Seyidova N, Schuh R, Windhager R, Hirtler L. Anatomical footprint of the tibialis anterior tendon: surgical implications for foot and ankle reconstructions. Biomed Res Int. 2017;2017:9542125.

    Article  Google Scholar 

  12. Varghese A, Bianchi S. Ultrasound of tibialis anterior muscle and tendon: anatomy, technique of examination, normal and pathologic appearance. J Ultrasound. 2013;17(2):113–23.

    Article  Google Scholar 

  13. Monteggia GB. Istituzioni Chirurgiche. Milan, Italy: Pirotta; 1803.

    Google Scholar 

  14. Ferran NA, Oliva F, Maffulli N. Recurrent subluxation of the peroneal tendons. Sports Med. 2006;36:839–46.

    Article  Google Scholar 

  15. Draghi F, Bortolotto C, Draghi AG, Gitto S. Intrasheath instability of the peroneal tendons: dynamic ultrasound imaging. J Ultrasound Med. 2018;37(12):2753–8. https://doi.org/10.1002/jum.14633.

    Article  PubMed  Google Scholar 

  16. Butler BW, Lanthier J, Wertheimer SJ. Subluxing peroneals: a review of the literature and case report. J Foot Ankle Surg. 1993;32:134–9.

    CAS  PubMed  Google Scholar 

  17. Ferran NA, Oliva F, Maffulli N. Ankle instability. Sports Med Arthrosc Rev. 2009;17:139–45.

    Article  Google Scholar 

  18. Maffulli N, Ferran NA, Oliva F, Testa V. Recurrent subluxation of the peroneal tendons. Am J Sports Med. 2006;34:986–92.

    Article  Google Scholar 

  19. Bianchi S, Delmi M, Molini L. Ultrasound of peroneal tendons. Semin Musculoskelet Radiol. 2010;14:292–306.

    Article  Google Scholar 

  20. Draghi F, Gregoli B, Bortolotto C. Absence of elevation of fibular tendons during dorsal hyperflexion of the foot: a sign of loss of the calcaneofibular ligament. J Ultrasound Med. 2014;33:1307–8.

    Article  Google Scholar 

  21. Taljanovic MS, Alcala JN, Gimber LH, Rieke JD, Chilvers MM, Latt LD. High-resolution US and MR imaging of peroneal tendon injuries. Radiographics. 2015;35:179–99.

    Article  Google Scholar 

  22. Raikin SM, Elias I, Nazarian LN. Intrasheath subluxation of the peroneal tendons. J Bone Joint Surg Am. 2008;90:992–9.

    Article  Google Scholar 

  23. Hsiao MY, Shyu SG, Wu CH, Ozcakar L. Dynamic ultrasound imaging for type A intrasheath subluxation of the peroneal tendons. Am J Phys Med Rehabil. 2015;94:e53–4.

    Article  Google Scholar 

  24. Lee SJ, Jacobson JA, Kim SM, et al. Ultrasound and MRI of the peroneal tendons and associated pathology. Skelet Radiol. 2013;42:1191–200.

    Article  Google Scholar 

  25. Brage ME, Hansen ST Jr. Traumatic subluxation/dislocation of the peroneal tendons. Foot Ankle. 1992;13:423–31.

    Article  CAS  Google Scholar 

  26. Opdam KT, van Dijk PA, Stufkens SA, van Dijk CN. The peroneus quartus muscle in a locking phenomenon of the ankle: a case report. J Foot Ankle Surg. 2017;56:108–11.

    Article  Google Scholar 

  27. Thomas JL, Lopez-Ben R, Maddox J. A preliminary report on intra-sheath peroneal tendon subluxation: a prospective review of seven patients with ultrasound verification. J Foot Ankle Surg. 2009;48:323–9.

    Article  Google Scholar 

  28. Gitto S, Draghi AG, Bortolotto C, Draghi F. Sonography of the Achilles tendon after complete rupture repair: what the radiologist should know. J Ultrasound Med. 2016;35(12):2529–36.

    Article  Google Scholar 

  29. Jozsa L, Kvist M, Balint BJ, et al. The role of recreational sport activity in Achilles tendon rupture: a clinical, pathoanatomical, and sociological study of 292 cases. Am J Sports Med. 1989;17:338–43.

    Article  CAS  Google Scholar 

  30. Leppilahti J, Orava S. Total Achilles tendon rupture: a review. Sports Med. 1998;25:79–100.

    Article  CAS  Google Scholar 

  31. Vosseller JT, Ellis SJ, Levine DS, et al. Achilles tendon rupture in women. Foot Ankle Int. 2013;34:49–53.

    Article  Google Scholar 

  32. Bleakney RR, White LM. Imaging of the Achilles tendon. Foot Ankle Clin. 2005;10:239–54.

    Article  Google Scholar 

  33. Pękala PA, Henry BM, Pękala JR, Piska K, Tomaszewski KA. The Achilles tendon and the retrocalcaneal bursa: an anatomical and radiological study. Bone Joint Res. 2017;6(7):446–51.

    Article  Google Scholar 

  34. Aronow MS. Posterior heel pain (retrocalcaneal bursitis, insertional and noninsertional Achilles tendinopathy). Clin Podiatr Med Surg. 2005;22:19–43.

    Article  Google Scholar 

  35. Mahlfeld K, Kayser R, Mahlfeld A, Grasshoff H, Franke J. Value of ultrasound in diagnosis of bursopathies in the area of the Achilles tendon. Ultraschall Med. 2001;22(2):87–90.

    Article  CAS  Google Scholar 

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Draghi, F. (2019). Tendons Around the Ankle. In: Ultrasonography of the Lower Extremity. Springer, Cham. https://doi.org/10.1007/978-3-030-14991-8_14

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  • DOI: https://doi.org/10.1007/978-3-030-14991-8_14

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