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MSK ultrasound > Ankle Anatomy and Pathology > Flashcards

Ankle Anatomy and Pathology Flashcards

1
Q

What three bones encompass the ankle joint?

A

Tibia, Fibula, Talus

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1
Q

Are flexors or extensors on the anterior foot?

A

Extensors

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2
Q

What are the three main tendons of the anterior ankle?

A

Tibialis Anterior
Extensor Hallucis Longus - attaches to big toe
Extensor Digitorum Longus - attaches to the rest of the phalanges

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3
Q

Where on the foot do you assess a tibiotalar joint effusion?

A) Lateral
B) Medial
C) Anterior
D) Posterior

A

Anterior aspect

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4
Q

What are the three bumps on the ankle that help form the ankle joint?

A

Medial malleolus
Lateral malleolus
Posterior malleolus

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5
Q

Synovitis in the anterior ankle is associated with what abnormality?

If RA is suspected, what metatarsal would you assess?

A

Rheumatoid arthritis

5th

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6
Q

Gout presents on ultrasound with monosodium urate crystal icing. What is this appearance called?

A

Double contour sign

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7
Q

Medial Ankle Pneumonic: Tom, Dick, And Very Very Nervous Harry. What does it stand for?

A
  1. Posterior TIBIAL tendon
  2. Flexor DIGITORUM longus tendon
  3. Posterior tibial ARTERY
  4. Posterior tibial VEINS (2)
  5. Posterior tibial NERVE
  6. Flexor HALLUCUS longus tendon
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8
Q

What two tendons does the “Knot of Henry” Involve?

A

FHL & FDL: The FDL crosses over top of the FHL on the medial aspect of the ankle and may cause intersection syndrome

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9
Q

T or F? The deltoid ligament on the medial ankle is easy to diagnose tears with ultrasound?

A

FALSE - it is difficult

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10
Q

The tarsal tunnel is a compartment formed by what two landmarks of the medial ankle?

A

Flexor retinaculum and distal tibia

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11
Q

Tarsal tunnel is the nerve entrapment of what nerve?

A

Tibial nerve

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12
Q

What aspect of the ankle is Tarsal Tunnel?
A) Lateral
B) Medial
C) Anterior
D) Posterior

A

B - medial

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13
Q

What are the names of the tendons on the lateral ankle?

A
  1. Peroneus Brevis
  2. Peroneus Longus
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14
Q

What are the ligaments of the lateral ankle?

A
  1. Anterior and posterior talofibular
  2. Anterior and posterior tibiofibular
  3. Calcaneofibular- the most commonly injured
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15
Q

An accessory anterior tibiofibular ligament in the lateral ankle may be present. What is the name for this ligament?

A

Bassett ligament

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16
Q

Tenosynovitis in the peroneal tendons is most common at the level of what landmark?

A

Lateral malleolus

17
Q

Anechoic / hypoechoic cleft that extends to the tendon surface in the lateral ankle is characteristic of what pathology?

A

Longitudinal tear/split

18
Q

A complete tendon tear in the lateral ankle most commonly occurs where? (hint: landmark)

A

Lateral malleolus

19
Q

Injury to what structure may result in subluxation or dislocation of the peroneal tendons?

A

Injury to the superior peroneal retinaculum

20
Q

T or F? A low-lying peroneus brevis muscle belly increases the risk for ankle pathology?

A

TRUE

21
Q

What tendon in the lateral ankle may be seen as an anatomical variant?

A

Peroneus Quartus

22
Q

Where can the peroneus quartus be found in relation to the fibula?

A

Posterior to the fibula

23
Q

The peroneus quartus may be mistaken for what pathology?

A

Longitudinal split/tear of the peroneus tendons

24
Q

Where does the achilles tendon insert?

A

The calcaneus

25
Q

Where does the plantaris muscle originate and insert?

A

O: The lateral femur
I: The calcaneus OR achilles

26
Q

What makes up the “triceps surae”?

A
  1. Gastroc
  2. Achilles
  3. Plantaris
27
Q

The retrocalcaneal bursae is located between which two structures?

A

Achilles and calcaneus

28
Q

Whats a normal measurement for the retrocalcaneal bursae?

A

up to 2.5mm

29
Q

The sonographic “mulder sign” is associated with what pathology?

A

Mortons Neuroma

30
Q

What metatarsal head should be assessed for Gout?

A) Medial first
B) Lateral first
C) Medial 2nd
D) Lateral 2nd

A

A) medial first

31
Q

Retrocalcaneal bursal distention has what features? (2)

A
  1. Tendon tear
  2. Inflammation
32
Q

T or F? The achilles tendon has a true tendon sheath?

A

False - it has a paratenon instead

33
Q

Abnormal hypoechoic swelling or anechoic fluid immediately adjacent to the achilles tendon represents what pathology?

A

Paratenonitis

34
Q

“A degenerative process, appears as abnormal tendon hypoechogenicity but without disruption of the tendon fibers” is known as what pathology?

A

Tendinosis - may present with vascularity

35
Q

How can we determine between a partial and full-thickness tear?

A

Dynamic Evaluation - have patient dorsiflex and plantar flex

36
Q

What are indirect signs of achilles tendon partial-thickness tear?

A
  1. Cortical irregularity of calcaneus
  2. Fluid within retro-calcaneal bursae
37
Q

What three features are associated with Haglund Syndrome?

A
  1. Distal achilles tendon abnormality
  2. Bursal distention
  3. Prominent posterosuperior corner of calcaneus
38
Q

Posterior acoustic shadowing from refraction at the tendon stumps is an indirect sign of what pathology?

A

Full-thickness tear of achilles tendon

39
Q

T or F? The plantaris tendon usually remains intact when there is a full-thickness tear in the achilles?

A

TRUE - plantaris is stronger

40
Q

What may mimic an intact achilles tendon when there is actually a full-thickness tear?

A

The plantaris tendon can be mistaken as it is right next to the achilles

41
Q

How many cuneiform bones are there?

A

3

MSK ultrasound (9 decks)

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