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Sonographic visibility of the sinus tarsi with a 12 MHz transducer

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Abstract

Objectives

To assess the value of ultrasonography in studies of the ligaments within the sinus tarsi (ST) in healthy subjects.

Materials and methods

We examined 20 healthy volunteers using a 12-MHz transducer with THI and compound imaging. With the foot in inversion, the following structures were examined with coronal and transverse scans: (1) the root of the inferior extensor retinaculum (RIER); (2) the interosseous talocalcaneal ligament (ITCL); (3) the cervical ligament (CL); (4) the bifurcate ligament (BL); (5) the synovial recesses, which were examined for possible distention (distended synovial recesses, DSR). The sonographic features, orientation, and thickness of each ligament were assessed.

Results

The easiest structure to identify (visualized in 20/20 subjects) was the RIER, which formed a semiarch. The two deeper layers were hypoechoic, the superficial layer hyperechoic. The ITCL was situated posteriorly and deep with an oblique course. It appeared hypoechoic with a mean thickness of 4.06 mm ± 0.7. It was visualized in 18/20 (90 %) subjects. The CL (isoechoic/hyperechoic) was located more anteriorly at an intermediate depth. The orientation was almost vertical. It was visualized in 17/20 (85 %) subjects, with a mean thickness of 2.28 mm ± 0.34. The BL appeared hypoechoic. It was visualized in 19/20 (95 %) subjects with transverse (anterior end of the ST) and longitudinal scans. The calcaneonavicular and calcaneocuboid components displayed mean (SD) thicknesses of 2.09 mm ± 0.37 and 2.7 mm ± 0.32, respectively. The ITCL and RIER were visualized in the same scan as a semiarch. DSR was observed in 4/20 (20 %) subjects.

Conclusions

The present study shows that, in patients with suspected ST pathology, the anatomic structures that make up this recess can be adequately examined with ultrasonography performed with ordinary 12-MHz transducers.

Sommario

Obiettivi

indagare la capacità degli ultrasuoni (US) di identificare le strutture legamentose del seno del tarso (ST) in un gruppo di soggetti sani.

Materiali e Metodi

abbiamo studiato 20 volontari sani, utilizzando sonde da 12 MHz, Compound e THI attivati. Sono stati indagati con piede in inversione: (1) radice del retinacolo inferiore degli estensori (RIER) (2) legamento interosseo (ITCL) (3) legamento cervicale (CL) (4) legamento biforcato (BL) (5) eventuali distensioni di recessi sinoviali (DSR), con scansioni coronali e trasversali, valutando ecostruttura, orientamento e spessore dei legamenti.

Risultati

(1) la RIER, repere ecografico, è stata la struttura di più agevole identificazione: con decorso a semiarco, ipoecogena nei 2 strati profondi, iperecogena in quello superficiale, visualizzata in 20/20 soggetti (2) il ITCL in situazione posteriore e profonda, con andamento obliquo ha presentato spessore medio di 4.06 mm ± 0.7, ipoecogeno, visualizzato in 18/20 (90 %); (3) il CL, più anteriore e orientamento quasi verticale, in situazione di profondità intermedia, iso/iperecogeno, visualizzato in 17/20(85 %), con spessore medio di 2,28 mm ± 0.34; (4) il BL, ipoecogeno, indagabile in scansione trasversale (estremità anteriore del ST) e longitudinale, visualizzato in 19/20 (95 %), con spessore medio 2,09 mm ± 0.37 (componente calcaneo-navicolare) e spessore medio 2,7 mm ± 0.32 (componente calcaneo-cuboidea). Il ITCL e il RIER hanno presentato (80 %) nella medesima scansione un aspetto a semicerchio. (5) sono stati riscontrati infine 4/20 (20 %) DSR.

Conclusioni

lo studio evidenzia la potenzialità degli US con comuni sonde da 12 MHz nell’individuare le strutture anatomiche che formano il ST nella prospettiva di approfondimenti anche per la patologia del recesso anatomico.

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Conflict of interest

Salvatore Massimo Stella, Barbara Ciampi, Eugenio Orsitto, Daniela Melchiorre, Piero Vincenzo Lippolisle declare that they have no conflict of interest.

Informed consent

The study was conducted in accordance with the ethical standards dictated by applicable law. Informed consent was obtained from each owner to enrolment in the study and to the inclusion in this article of information that could potentially lead to their identification.

Human and animal studies

The study described in this article does not contain studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Ospedale di Misericordia di Navacchio, via Ruschi 34, 56011, Calci, PI, Italy

    Salvatore Massimo Stella

  2. Ospedale di Misericordia di Navacchio, Navacchio, Cascina, Pisa, Italy

    Barbara Ciampi

  3. Radiologia D.E.A., A.O.U.P. Ospedale Cisanello Pisa, Pisa, Italy

    Eugenio Orsitto

  4. Reumatologia Universitaria di Firenze, Ospedale Careggi Firenze, Florence, Italy

    Daniela Melchiorre

  5. U.O. Chirurgia Generale e d’Urgenza, A.O.U.P., Ospedale Cisanello Pisa, Pisa, Italy

    Piero Vincenzo Lippolis

  6. Scuola SIUMB di Ecografia di Base e Specialistica in Urgenza ed Emergenza di Pisa, Pisa, Italy

    Piero Vincenzo Lippolis

Authors
  1. Salvatore Massimo Stella
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  2. Barbara Ciampi
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  3. Eugenio Orsitto
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  5. Piero Vincenzo Lippolis
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Correspondence to Salvatore Massimo Stella.

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Stella, S.M., Ciampi, B., Orsitto, E. et al. Sonographic visibility of the sinus tarsi with a 12 MHz transducer. J Ultrasound 19, 107–113 (2016). https://doi.org/10.1007/s40477-014-0145-y

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  • DOI: https://doi.org/10.1007/s40477-014-0145-y

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