Table Of ContentMEDICAL RADIOLOGY
Diagnostic Imaging
Editors:
A. L. Baert, Leuven
K. Sartor, Heidelberg
Springer
Berlin
Heidelberg
New York
Hong Kong
London
Milan
Paris
Tokyo
A. M. Davies· R.W. Whitehouse· J. P. R. Jenkins
(Eds.)
Imaging
of the
&
Foot Ankle
Techniques and Applications
With Contributions by
T. D. Berg· T. H. Berquist· S. Bianchi· S. L. Burrows· V. N. Cassar-Pullicino
V. P. Chandnani . M. Cobby . A. M. Davies· B. J. DeMichaelis . G. Y. EI-Khoury
J. M. Elliott· S. J. Erickson· J. Garcia· H. K. Genant . A. Gentili . A. J. Grainger
J. W. Helgason . S. Hofmann· H. Imhof· J. P. R. Jenkins· F. Kainberger . A. Katz
J. Kramer· G. Lavis· H. P. Ledermann . C. Martinoli . E. G. McNally· W. B. Morrison
S. Nehrer . M. Recht· P. Renton· D. A. Ritchie· L. L. Seeger· M. E. Schweitzer
B. Tins· P. N. M. Tyrrell· D. Vanel . H. Vogel· 1. Watt· R. W. Whitehouse· J. S. Yu
Foreword by
A.L. Baert
With 451 Figures in 753 Separate Illustrations, 11 in Color and 35 Tables
Springer
A.MARK DAVIES, MD JEREMY P. R. JENKINS, MBChB, FRCP, DMRD, FRCR
Consultant Radiologist Department of Clinical Radiology
The MRI Centre Manchester Royal Infirmary
Royal Orthopaedic Hospital Oxford Road
Birmingham B31 2 AP Manchester, M13 9WL
UK UK
RICHARD WILLIAM WHITEHOUSE, MD
Department of Clinical Radiology
Manchester Royal Infirmary
Oxford Road
Manchester, M13 9WL
UK
MEDICAL RADIOLOGY' Diagnostic Imaging and Radiation Oncology
Series Editors: A. L. Baert • L. W. Brady· H.-P. Heilmann· M. Molls· K. Sartor
Continuation of
Handbuch der medizinischen Radiologie
Encyclopedia of Medical Radiology
ISBN-13: 978-3-642-63950-0 e-ISBN-13: 978-3-642-59363-5
DOl: 10.1007/978-3-642-59363-5
Library of Congress Cataloging-in-Publication Data
Imaging of the foot & ankle: techniques and applications 1 A. M. Davies, R. W.
Whitehouse, J. P. R. Jenkins (eds.); with contributions by T. Berg ... let al.l ; foreword by
A. 1. Baert.
p. ; cm. --(Medical radiology)
Includes bibliographical references and index.
1. Foot--Imaging. 2. Ankle--Imaging. 3. Foot--Diseases--Diagnosis. 4.
Ankle--Diseases--Diagnosis. I. Title: Imaging of the foot and ankle. II Davies, A. M.
(Arthur Mark), 1954- III. Whitehouse, Richard W. IV. Jenkins, J. P. R. (Jeremy P. R.) V.
Berg, T. (Thomas) VI. Series.
[DNLM: 1. Foot Diseases--diagnosis. 2. Ankle Injuries--diagnosis. 3. Diagnostic
Imaging--methods. 4. Foot Injuries--diagnosis. WE 880 131 2002]
RC951 .14342002
617.5 '850757--dc21
2002070776
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Foreword
This volume provides a multimodality imaging approach to the pathology of the foot
and the ankle, covering both the various imaging techniques and all clinical aspects of
diseases of these anatomic areas.
The chapters on technique are compact but still deal comprehensively with all spe
cific facets of the problem. The clinical chapters are well written, detailed and superbly
illustrated.
The editors succeeded in assembling an excellent group of international experts from
the European continent as well as from the USA to cover all commonly held modern
views and concepts on the topic.
This outstanding volume will serve the needs not only of general radiologists dealing
in their daily practice with the frequently occurring traumatic conditions of the ankle
and foot but also of specialised musculoskeletal radiologists looking for guidance in
their management of patients suffering from arthritis, osteochondritis, infectious or
metabolic diseases or even the rare tumoral and tumour-like conditions of this part of
the lower limb. It can be recommended highly as invaluable reading not only to radiolo
gists but also to orthopaedic surgeons and rheumatologists.
I am confident that this excellent book will meet the same success as the volume on
the knee already published in this series by Dr. Mark Davies.
Leuven ALBERT 1. BAERT
Preface
As our understanding of the disease processes and biomechanics of foot and ankle
disorders improves there is a need to continuously update the radiologists, orthopaedic
surgeons and other professions working in this field. Several recent texts on the foot and
ankle have concentrated on a single imaging technique such as MR imaging. This book,
in common with several others published in this series, takes a dual approach to the sub
ject. The first section acquaints the reader with the full range of techniques available for
imaging the ankle and foot pathology, emphasising indications and contraindications.
The seven chapters include contributions on radiography, computed tomography, MR
imaging and ultrasound. The remaining fifteen chapters discuss the optimal application
of these techniques to specific pathologies, highlighting practical solutions to everyday
clinical problems.
The editors are grateful to the international panel of authors for their contributions
to this book, which aims to provide a comprehensive overview of current imaging of the
foot and ankle.
Birmingham A. MARK DAVIES
Manchester RICHARD WILLIAM WHITEHOUSE
Manchester JEREMY P. R. JENKINS
Contents
Imaging Techniques and Procedures .......................................... .
Radiography
AMILCARE GENT ILl and LEANNE 1. SEEGER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2 Anatomy, Arthrography, Bursography and Tenography of the Ankle and Foot
VICTOR N. CASSAR-PULLICINO and BERNARD TINS. . . . . . . . . . . . . . . . . . . . . . . . . . .. 27
3 Computed Tomography (CT) and CT Arthrography
RICHARD WILLIAM WHITEHOUSE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 43
4 MRI
JEREMY P. R JENKINS ...................................................... 61
5 MR Arthrography of the Ankle
J. WALTER HELGASON and VIJAY P. CHANDNANI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 85
6 Ultrasound Imaging of the Ankle
STEFANO BIANCHI, CARLO MARTINOLI, and JEAN GARCIA. . . . . . . . . . . . . . . . . . . . .. 95
7 Intra-articular Injections of the Ankle and Foot
BRIAN J. DE MICHAELIS, S. LEON BURROWS, THOMAS D. BERG,
and GEORGES Y. EL-KHOURY ............................................... 107
Clinical Problems ........................................................... 113
8 Congenital and Developmental Disorders
PETER RENTON ........................................................... 115
9 Bone Trauma
PRUDENCIA N. M. TYRRELL and VICTOR N. CASSAR-PULLICINO ................. 145
10 Tendon Pathology
FRANZ KAINBERGER, STEFAN NEHRER, and HERWIG IMHOF .................... 167
11 Ligament Pathology
ALLEN KATZ and SCOTT J. ERICKSON ....................................... 179
12 Compressive Neuropathies and Plantar Fascial Lesions
JOSEPH S. Yu ............................................................. 201
13 Infection
HANS PETER LEDER MANN, WILLIAM B. MORRISON, and MARK E. SCHWEITZER ... 215
14 The Diabetic Foot
HANS PETER LEDERMANN, WILLIAM B. MORRISON, and MARK E. SCHWEITZER ... 233
15 Arthritis
MARK COBBY and lAIN WATT .............................................. 251
16 Metabolic Bone Disease
ANDREW J. GRAINGER, J. MARK ELLIOT, and HARRY K. GENANT ................ 263
17 Osteonecrosis and Osteocho~dritis
JOSEF KRAMER, SIEGFRIED HOFMANN, and MICHAEL RECHT ................... 279
18 Acquired Deformities of the Foot and Ankle
EUGENE G. McNALLY and GRAHAME LAVIS .................................. 293
19 Sesamoid Pathology
WILLLIAM B. MORRISON, HANS PETER LEDERMANN, and MARK E. SCHWEITZER .. 313
20 Tumours and Tumour-like Lesions
DAVID A. RITCHIE, A. MARK DAVIES, and DANIEL VANEL ....................... 325
21 Orthopaedic Hardware
THOMAS H. BERQUIST ..................................................... 351
22 Sequelae of Torture
HERMANN VOGEL ......................................................... 367
Subject Index ............................................................... 373
List of Contributors .......................................................... 379
Imaging Techniques and Procedures
1 Radiography
A. GENTILI and L. L. SEEGER
CONTENTS 1.1.2.5 Sesamoid Projection 14
1.1.2.5.1 Technique 14
1.1 Radiographic Technique 4 1.1.2.5.2 Radiographic Evaluation 14
1.1.1 Radiographic Projections of the Ankle 4 1.1.3 Radiographic Projections of the Toes 14
1.1.1.1 Anteroposterior Projection of the Ankle 4 1.1.3.1 Anteroposterior (Dorsoplantar) Projection
1.1.1.1.1 Technique 4 of the Toes 14
1.1.1.1.2 Radiographic Evaluation 4 1.1.3.1.1 Technique 15
1.1.1.2 Lateral Projection of the Ankle 5 1.1.3.1.2 Radiographic Evaluation 15
1.1.1.2.1 Technique 5 1.1.3.2 Lateral Projection of the Toes 15
1.1.1.2.2 Radiographic Evaluation 5 1.1.3.2.1 Technique 15
1.1.1.3 Mortise Projection of the Ankle 5 1.1.3.2.2 Radiographic Evaluation 15
1.1.1.3.1 Technique 5 1.1.3.3 Oblique Projection of the Toes 15
1.1.1.3.2 Radiographic Evaluation 8 1.1.3.3.1 Technique 15
1.1.1.4 45° Medial and Lateral Oblique Projections 1.1.3.3.2 Radiographic Evaluation 16
of the Ankle 8 1.1.4 Calcaneal Projections 17
1.1.1.4.1 Technique 8 1.1.4.1 Axial Calcaneal Projection 17
1.1.1.4.2 Radiographic Evaluation 8 1.1.4.1.1 Technique 17
1.1.1.5 'Off' Lateral or 'Poor' Lateral Projection 1.1.4.1.2 Radiographic Evaluation 17
of the Ankle 8 1.1.4.2 Lateral Calcaneal Projection 17
1.1.1.5.1 Technique 8 1.1.4.2.1 Technique 17
1.1.1.5.2 Radiographic Evaluation 8 1.1.4.2.2 Radiographic Evaluation 18
1.1.1.6 Anteroposterior Stress Projections 8 1.2 Foot Angle and Axis 19
(Inversion - Varus and Eversion - Valgus Stress) 1.2.1 Axes and Angles on the Dorsoplantar
1.1.1.6.1 Technique 8 Projection 19
1.1.1.6.2 Radiographic Evaluation 10 1.2.1.1 Longitudinal Axis of the Rearfoot 19
1.1.1.7 Lateral Stress Views 10 1.2.1.2 Collum Tali Axis 19
1.1.1.7.1 Technique 10 1.2.1.3 Talocalcaneal Angle 19
1.1.1.7.2 Radiographic Evaluation 10 1.2.1.4 Cuboid Abduction Angle 19
1.1.2 Radiographic Projections of the Foot 10 1.2.1.5 Longitudinal Axis of the Lesser Tarsus 19
1.1.2.1 Anteroposterior (Dorsoplantar) Projection 1.2.1.6 Lesser Tarsus Angle 20
of the Foot 10 1.2.1.7 Talonavicular Angle 20
1.1.2.1.1 Technique 10 1.2.1.8 Longitudinal Axis of the Metatarsus 20
1.1.2.1.2 Radiographic Evaluation 11 1.2.1.9 Forefoot Adductus Angle 20
1.1.2.2 Lateral Projection of the Foot 12 1.2.1.10 Metatarsus Adductus Angle 20
1.1.2.2.1 Technique 12 1.2.1.11 First Intermetatarsal Angle 20
1.1.2.2.2 Radiographic Evaluation 12 1.2.1.12 Hallux Valgus Angle 20
1.1.2.3 Medial Oblique Projection of the Foot 13 1.2.1.13 Proximal and Distal Articular Set Angles 21
1.1.2.3.1 Technique 13 1.2.1.14 Hallux Interphalangeal Angle 21
1.1.2.3.2 Radiographic Evaluation 13 1.2.2 Axes and Angles on the Lateral Projection 21
1.1.2.4 Lateral Oblique Projection of the Foot 13 1.2.2.1 Plane of Support 21
1.1.2.4.1 Technique 13 1.2.2.2 Collum Tali Axis 21
1.1.2.4.2 Radiographic Evaluation 13 1.2.2.3 Talar Declination Angle 22
1.2.2.4 Calcaneal Axis or Calcaneal Inclination Axis 22
1.2.2.5 Lateral Talocalcaneal Angle 22
A. GENTILI, MD 1.2.2.6 First Metatarsal Declination Axis 22
Professor of Radiology, UCSD Thornton Hospital, Depart 1.2.2.7 First Metatarsal Declination Angle 22
ment of Radiology, 9300 Campus Point Drive, 7756, La Jolla, 1.2.2.8 Calcaneal Inclination Angle 22
CA 92037, USA 1.2.2.9 Biihler's Angle 23
L.L. SEEGER, MD 1.3 Normal Variants: Sesamoid Bones
Professor, Dept. of Radiological Sciences, 200 UCLA Medical and Accessory Ossicles 23
Plaza, Suite 165-57, Los Angeles, CA 90095-6952, USA References 25
