MRI of the foot and ankle Flashcards
usually affected tendons of foot pathologically
flexor tendons, located posterior in the ankle
tenosynovitis in achilles tendon does not occur because
it does not have a sheath associated with it
achilles tendon rupture can be treated by
surgically or by placing the patient in a case with equinus positioning (marked plantar flexion) for several months
flexor tendons includes
“Tom, Dick and Harry” posterior tibial tendon, Flexor digitorum longus tendon, Flexor hallucis longus tendon
most medial and largest flexor tendon
posterior tibial tendon
posterior tibial tendon inserts onto the (7)
- navicular,
- second and third cuneiforms and
- bases of the second to fourth metatarsals
problems in the arch or plantar fascia can sometimes lead to stress on the
posterior tibial tendon
treatment for PTT tendinosis and partial tears is
nonoperative
rupture of posterior tibial tendon results clinically in
flat foot due to loss of arch support given by PTT
ligament that runs just deep to the PTT and then goes underneath the neck of talus, which it supports in a sling-like fashion
spring ligament
sling-like = SS = spring
when the spring ligament is stressed, it appears
scarred and thickened
usually the only tendon near the tibiotalar joint
flexor hallucis longus tendon
tendon that can be seen beneath the sustentaculum tali, which it uses as pulley to plantar flex the foot
flexor hallucis longus tendon
known as the achilles tnedon of the foot in ballet dancers because of the extreme flexion positions they employ
flexor hallucis longus tendon
tendons that can be seen posterior to the distal fibula, to which they are bound by a thin fibrous structure, the superior peroneal retinaculum
peroneus longus and peroneus brevis tendons
serves as a pulley for the tendons to work as the principal evertor of the foot
fibula
peroneus brevis tendon inserts onto
base of the 5th metatarsal
peroneus longus tendon crosses under the foot and inserts onto the
base of the first metatarsal
LONG FIRST
disruption of this structure, often seen in skiing accidents, can result in lateral displacement of peroneus tendons, and must be surgically corrected. it sometimes occurs with a small bony avulsion, called a flake fracture, off the fibula
superior peroneal retinaculum
commonly seen in patients following an inversion ankle sprain with associated dorsiflexion
longitudinal split tears of peroneus brevis
also occurs with inversion trauma of the ankle, these patients have chronic lateral ankle pain, often associated with ankle instability
lateral collateral ligament disruption
V-shape or chevron defect to the tendon distal to the fibula
split tear of peroneus brevis
split tear of peroneus brevis are associated with _____ 80% of the time
lateral ligament tears
second most common location of an osteochondral lesion or osteochondritis dissecans
talar dome
3 tumors that have a predilection for foot and ankle
synovial sarcomas, desmoid tumors, giant cell tumor
MRI appearance of foot and ankle tumors
marked low signal in the synovial lining and in the tendons on T1 and T2 images, just as pigmented villonodular synovitis appears in a joint
soft tissue tumors in the medial aspect of the foot and ankle can press on the posterior tibial nerve, resulting in
tarsal tunnel syndrome
nerve that is compressed in tarsal tunner syndrome
posterior tibial nerve
posterior tibial nerve is bounded medially by ____, a strong fibrous band that extends across the medial ankle joint for approximately 5 to 7 cm in a superior to inferior direction
flexor retinaculum
most common accessory muscles encountered around the foot and ankle
accessory soleus and peroneus brevis muscles
injured in over 90% of ankle sprains
lateral ligaments
lateral complex ligaments are composed of two groups, the superior group contains _________ that make up part of syndesmosis
anterior and posterior tibiofibular ligaments
inferior group in lateral complex ligaments contain
anterior and posterior talofibular ligaments and calcaneofibular ligament
ligaments that are seen on axial images just below the tibiotalar joint and emanate from a concavity in the distal fibula called malleolar fossa
anterior and posterior talofibular ligaments
most commonly torn ankle ligament is the
anterior talofibular ligament
present with lateral ankle pain and tenderness and a perception of hindfoot instability
sinus tarsi syndrome
cone-shped space between the talus and calcaneus that opens up laterally. it is a fat-filled space through which traverse several important ligaments that provide subtalar stability
sinus tarsi
results from hypertrophy and scarring of the synovium in the lateral gutter of the ankle
anterolateral impingement syndrome
space between the tibia and the fibula and is bound by the lateral ankle ligaments
lateral gutter
presents with lateral ankle pain and inability to dorsiflex normally. they often have a click on dorsiflexion
anterolateral impingement syndrome
common cause of a painful flat foot. occurs most commonly at the calcaneonavicular joint and the middle facet of the talocalcaneal joint
tarsal coalition
definitive MR finidngs for osteomyelitis are
cortical disruption, a bony abscess or a sinus track
