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Ankle pain and anatomy

T Grieser
CLINICAL ISSUE: Both benign and malignant tumours are encountered in the foot and ankle. Due to their rarity, however, diagnosis is often uncertain. Usual criteria such as tumour size, invasiveness or pain fail to differentiate benign from malignant neoplasias. STANDARD RADIOLOGICAL METHODS: Plain radiography and-due to the complex foot anatomy-CT are important in the diagnostic evaluation of primary bone tumours. In the case of soft tissue tumours, ultrasonography is used to identify ganglion cysts...
February 28, 2018: Der Radiologe
Bin Yuan, Bao-Jian Ge, Bai-Yi Meng
Dislocation of proximal tibiofibular joint(PTFJ) is relatively infrequent in clinic, it can be either isolated or associated with tibia fracture, fibular fracture and ankle injury and so on. Chronic symptomatic PTFJ instability are easily mixed with meniscal tears. It was easily neglected because of the mild clinical presentation and atypical change on radiography. Early diagnosis and treatment are crucial to prevent chronic knee pain and instability. The paper concluded the anatomy, classification, complication, diagnosis, treatment, clinical effect and insufficient of the dislocation of PTFJ, to direct the diagnosis and treatment of proximal tibiofibular joint dislocation in clinical work...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Rose E Cortina, Brandon L Morris, Bryan G Vopat
Metatarsalgia is a common cause of plantar forefoot pain. Causes of metatarsalgia include foot anatomy, gait mechanics, and foot and ankle deformity. One specific cause, mechanical metatarsalgia, occurs because of gastrocnemius muscle contracture, which overloads the forefoot. Muscular imbalance of the gastrocnemius complex alters gait mechanics, which increases recruitment of the toe extensor musculature, thereby altering forefoot pressure. Patients with concomitant metatarsalgia and gastrocnemius contracture demonstrate ankle equinus and a positive Silfverskiold test...
March 2018: Foot and Ankle Clinics
R García Jiménez, F J García-Gómez, E Noriega Álvarez, C Calvo Morón, J J Martín-Marcuartu
Disorders of the foot and ankle are some of the most frequent ones affecting the musculoskeletal system and have a great impact on patients' quality of life. Accurate diagnosis is an important clinical challenge because of the complex anatomy and function of the foot, that make it difficult to locate the source of the pain by routine clinical examination. In the study of foot pathology, anatomical imaging (radiography, magnetic resonance imaging [MRI], ultrasound and computed tomography [CT]) and functional imaging (bone scan, positron emission tomography [PET] and MRI) techniques have been used...
December 6, 2017: Revista Española de Medicina Nuclear e Imagen Molecular
Rakesh V Sondekoppam, Vivian Ip, David F Johnston, Vishal Uppal, Marjorie Johnson, Sugantha Ganapathy, Ban C H Tsui
BACKGROUND: The anterior iliac crest (AIC) is one of the most common sites for harvesting autologous bone, but the associated postoperative pain can result in significant morbidity. Recently, the transmuscular quadratus lumborum block (TQL) has been described to anesthetize the thoraco-lumbar nerves. This study utilizes a combination of cadaveric models and clinical case studies to evaluate the dermatomal coverage and analgesic utility of TQL for AIC bone graft donor site analgesia. METHODS: Ten ultrasound-guided TQL injections were performed in five cadaver specimens using a lateral-to-medial transmuscular approach...
November 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
James W Brodsky, Jacob R Zide, Justin M Kane
A high clinical suspicion and greater understanding of the anatomy and pathophysiology of lateral ankle injuries have enabled early diagnosis and treatment-improving outcomes of acute peroneal tendon tears. Multiple conditions can be the cause of lateral ankle pain attributed to the peroneal tendons: tenosynovitis, tendinosis, subluxation and dislocation, stenosing tenosynovitis, abnormality related to the os peroneum, as well as tears of the peroneal tendons. It is imperative for the clinician to maintain a high suspicion for peroneal tendon abnormality when evaluating patients with lateral ankle pain...
December 2017: Foot and Ankle Clinics
Thomas Hodo, Mark Hamrick, Yulia Melenevsky
Musculoskeletal anatomy is widely known to have components that stray from the norm in the form of variant muscle and tendon presence, absence, origin, insertion, and bifurcation. Although these variant muscles and tendons might be deemed incidental and insignificant findings by most, they can be important contributors to pathologic physiology or, more importantly, an option for effective treatment. In the present case report, we describe a patient with phocomelia and Müllerian abnormalities secondary to in utero thalidomide exposure...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Kinner Davda, Karan Malhotra, Paul O'Donnell, Dishan Singh, Nicholas Cullen
Pathological abnormality of the peroneal tendons is an under-appreciated source of lateral hindfoot pain and dysfunction that can be difficult to distinguish from lateral ankle ligament injuries.Enclosed within the lateral compartment of the leg, the peroneal tendons are the primary evertors of the foot and function as lateral ankle stabilisers.Pathology of the tendons falls into three broad categories: tendinitis and tenosynovitis, tendon subluxation and dislocation, and tendon splits and tears. These can be associated with ankle instability, hindfoot deformity and anomalous anatomy such as a low lying peroneus brevis or peroneus quartus...
June 2017: EFORT open reviews
Hong-Geun Jung, Na-Ra Kim, Ji-Young Jeon, Dong-Oh Lee, Jun-Sang Eom, Jong-Soo Lee, Sung-Wook Kim
PURPOSE: Little is known about the arthroscopic or radiographic outcomes after arthroscopic microfracture of osteochondral lesions of the talus (OLTs). The purpose of this study was to investigate tissue growth after arthroscopic microfracture of OLTs using computed tomography arthrography (CTA) and to identify the relationship between CTA findings and clinical outcomes. We hypothesized that the morphology of the repaired tissue would be similar to that of normal anatomy and correlate with the clinical outcomes...
June 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Yogesh Kumar, Ali Alian, Shivani Ahlawat, Dane K Wukich, Avneesh Chhabra
Peroneal tendon pathology is an important cause of lateral ankle pain and instability. Typical peroneal tendon disorders include tendinitis, tenosynovitis, partial and full thickness tendon tears, peroneal retinacular injuries, and tendon subluxations and dislocations. Surgery is usually indicated when conservative treatment fails. Familiarity with the peroneal tendon surgeries and expected postoperative imaging findings is essential for accurate assessment and to avoid diagnostic pitfalls. Cross-sectional imaging, especially ultrasound and MRI provide accurate pre-operative and post-operative evaluation of the peroneal tendon pathology...
July 2017: European Journal of Radiology
C Xu, M Li, C Wang, K Li, H Liu
INTRODUCTION: Both the overall shape of the calcaneus and anatomical reduction of joint congruity are important prognostic factors. However, there is a significant lack of biomechanical data supporting the clinical importance of calcaneus height, length and heel width. The objective of this study was to determine the effects of abnormal calcaneus morphology on ankle-hindfoot biomechanics. HYPOTHESIS: The normal biomechanics of the ankle-hindfoot would be severely disrupted by the abnormal calcaneus morphology...
September 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Cristina Hernández-Díaz, José Alvarez-Nemegyei, José Eduardo Navarro-Zarza, Pablo Villaseñor-Ovies, Robert A Kalish, Juan J Canoso, Angélica Vargas, Karla Chiapas-Gasca, Joseph J Biundo, Francisco Javier de Toro Santos, Dennis McGonagle, Simon Carette, Miguel Ángel Saavedra
This study aimed to generate a minimum list of structural and functional anatomical items about the pelvis/hip, knee, ankle/foot, gait, and lower limb innervation, which are most relevant to the practice of rheumatology. To determine their perceived relevance to clinical practice, seven members of the Mexican Clinical Anatomy Task Force compiled an initial list of 470 anatomical items. Ten local and international experts according to a 0-10 Likert scale ranked these items. Of the original list, 101 (21.48%) items were considered relevant (global rate >40)...
December 2017: Clinical Rheumatology
Markus Preis, Travis Bailey, Lucas S Marchand, Alexej Barg
BACKGROUND: In patients with painful ankle arthrodesis, the surgical treatment is challenging, and may include takedown of ankle arthrodesis and conversion to a total ankle replacement (TAR). This procedure is technically demanding given the altered anatomy after arthrodesis. Few studies have evaluated TAR in the setting of prior arthrodesis. QUESTIONS/PURPOSES: (1) What intraoperative and perioperative complications were observed in patients who underwent conversion of an ankle arthrodesis to a TAR? (2) Was durable fixation achieved at short term, and what was the alignment of the components? (3) What subsequent surgical procedures were performed, including revisions? (4) What improvements were observed in pain, tibiotalar range of motion (ROM), and quality of life? METHODS: Between January 2007 and December 2014, 18 patients with a painful ankle arthrodesis underwent conversion to TAR at our tertiary referral center...
September 2017: Clinical Orthopaedics and related Research
Matthew Winfeld, Nancy Chauvin
We present the case of a 15-year-old teenager who sustained an ankle inversion injury while playing American football, which yielded only minimal pain, but also foot numbness and a lateral leg bulge. Magnetic resonance imaging evaluation revealed a proximal peroneal tear. These rare injuries are often associated with compartment syndrome, a surgical emergency, which was ultimately excluded clinically in this patient. Relevant anatomy, mechanism of injury, and clinical manifestations are discussed.
July 2017: Skeletal Radiology
Xiang Ren, Liu Yang, Xiao-Jun Duan
Surgical excision is the traditional treatment for osteoid osteoma. However, the complexity of the foot anatomy makes a satisfactory outcome challenging. Difficulty in localizing the lesion intraoperatively may result in either incomplete tumor resection or excessive bone loss. To date, no published report has described the use of three-dimensional printing in the surgical treatment of osteoid osteoma of the calcaneus. In this case, we printed a three-dimensional model of the calcaneus of a 17-year-old female patient with a 2-year history of night pain in the lateral aspect of the hindfoot and ankle, evaluated the lesion as an osteoid osteoma, and designed a surgical guiding plate...
February 2017: Journal of International Medical Research
Stefano Bianchi, Chandra Bortolotto, Ferdinando Draghi
The os peroneum (OP) is a small sesamoid bone located inside the peroneus longus tendon (PLT), close to the cuboid. The OP can be the cause of pain and can be associated with lesions of the PLT. OP involvement in PLT disorders is frequently misdiagnosed by radiologists. Painful os peroneum syndrome (POPS) refers to a variety of conditions presenting with pain localized on the lateral aspect of the cuboid area. The syndrome can be observed as a consequence of local acute trauma such as ankle sprains or chronic overuse...
February 2017: Insights Into Imaging
Jay Smith, Håkan Alfredson, Lorenzo Masci, Jacob L Sellon, Charonn D Woods
BACKGROUND: Differential motion between the plantaris and Achilles tendons has been hypothesized to contribute to pain in some patients presenting with Achilles tendinopathy. However, objective evidence of differential Achilles-plantaris motion is currently lacking from the literature. OBJECTIVE: To determine whether differential, multidirectional motion exists between the plantaris tendon (PT) and Achilles tendon (AT) as documented by dynamic ultrasound (US) and postdissection examination in an unembalmed cadaveric model...
October 24, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Michael H Theodoulou, Laura Bohman
Posterior ankle pain can occur for many reasons. If it is produced by forced plantarflexion of the foot, it is often a result of impingement from an enlarged posterior talar process or an os trigonum. This condition may present in an acute or chronic state. Management is initially nonoperative, but surgical treatments are available. This condition is often seen in athletes, so procedures that limit surgical trauma and allow early return to activity are ideal. An arthroscopic approach for this disorder produces good outcomes with limited complications...
October 2016: Clinics in Podiatric Medicine and Surgery
Jason M Souza, Chad A Purnell, Jennifer E Cheesborough, Armen S Kelikian, Gregory A Dumanian
BACKGROUND: Localized nerve pain in the foot and ankle can be a chronic source of disability after trauma and has been identified as the most common complication following operative interventions in the foot and ankle. The superficial location of the injured nerves and lack of suitable tissue for nerve implantation make this pain refractory to conventional methods of neuroma management. We describe a novel strategy for management using processed nerve allografts to bridge nerve gaps created by resection of both end neuromas and neuromas-in-continuity...
October 2016: Foot & Ankle International
Alieh Daryabor, Mokhtar Arazpour, Mohammad Samadian, Masoumeh Veiskarami, Monireh Ahmadi Bani
BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a progressive growth disease that affects spinal anatomy, mobility, and left-right trunk symmetry. As a consequence, AIS can modify human gait. Spinal orthoses are a commonly used conservative method for the treatment of AIS. OBJECTIVE: This review evaluated the AIS spinal orthosis literature that involved gait and energy consumption evaluations. STUDY DESIGN: Literature review. METHOD: According to the population intervention comparison outcome measure methods and based on selected keywords, 10 studies met the inclusion criteria...
May 2017: Disability and Rehabilitation. Assistive Technology
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