Imaging of the Foot & Ankle: Techniques and Applications PDF
Preview Imaging of the Foot & Ankle: Techniques and Applications
MEDICAL 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 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitations, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law. Springer-Verlag Berlin Heidelberg New York a member of BertelsmannSpringer Science+Business Media GmbH httpllwww.springer.de © Springer-Verlag Berlin Heidelberg 2003 Softcover reprint of the hardcover 1st edition 2003 The use of general descriptive names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every case the user must check such information by consulting the relevant literature. Cover-Design and Typesetting: Verlagsservice Teichmann, 69256 Mauer 21/3150 - 5 4 3 2 1 0 - Printed on acid-free paper 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
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