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Sonographic anatomy of the ankle

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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.

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.

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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.

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Authors and Affiliations

  1. AO Provincia di Pavia, Ospedale Civile di Voghera, Voghera, Italy

    M. Precerutti

  2. Fondazione IRCCS, Policlinico San Matteo di Pavia, UO Radiodiagnostica, Pavia, Italy

    M. Bonardi

  3. Dipartimento di Radiologia, Ospedale Guglielmo da Saliceto, Piacenza, Italy

    G. Ferrozzi

  4. Istituto di Radiologia, Policlinico San Matteo, Università di Pavia, Pavia, Italy

    F. Draghi

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  1. M. Precerutti
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  2. M. Bonardi
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  3. G. Ferrozzi
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  4. F. Draghi
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Correspondence to M. Precerutti.

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Precerutti, M., Bonardi, M., Ferrozzi, G. et al. Sonographic anatomy of the ankle. J Ultrasound 17, 79–87 (2014). https://doi.org/10.1007/s40477-013-0025-x

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  • DOI: https://doi.org/10.1007/s40477-013-0025-x

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