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Cockerill SJ, Arnay-de-la-Rosa M, González-Reimers E. An atlas of anatomical variants of the human calcaneus. J Morphol 2024; 285:e21706. [PMID: 38704702 DOI: 10.1002/jmor.21706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 05/07/2024]
Abstract
The usefulness of anatomical variation is determined by the knowledge of why nonmetric traits appear. Clear descriptions of the traits are a necessary task, due to the risk of confusing anatomical variants and evidence of trauma. Numerous interpretations of the appearance of calcaneal anatomical variants add to the need of an anatomical atlas of calcaneal nonmetric traits. We have analyzed a total of 886 calcanei; 559 belong to different modern and pre-Hispanic samples, and 327 bones were studied from a reference collection from Athens. In this study, we present the anatomical variations that exist on the calcaneus bone, some of which have rarely been mentioned in previous research. The standardization of methods proposed may be useful to experts working in human anatomy, physical anthropology as well as comparative morphology, due to usefulness of this information during surgery, and bioanthropology to observe and study the lifestyle of past populations.
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Affiliation(s)
- Samuel James Cockerill
- Departamento Geografía e Historia, Facultad de Humanidades, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Matilde Arnay-de-la-Rosa
- Departamento Geografía e Historia, Facultad de Humanidades, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Emilio González-Reimers
- Dpto. de Medicina Interna, Hospital Universitario de Canarias, Universidad de La Laguna, La Laguna, Spain
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Bajaj S, Chhabra A, Taneja AK. 3D isotropic MRI of ankle: review of literature with comparison to 2D MRI. Skeletal Radiol 2024; 53:825-846. [PMID: 37978990 DOI: 10.1007/s00256-023-04513-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
The ankle joint has complex anatomy with different tissue structures and is commonly involved in traumatic injuries. Magnetic resonance imaging (MRI) is the primary imaging modality used to assess the soft tissue structures around the ankle joint including the ligaments, tendons, and articular cartilage. Two-dimensional (2D) fast spin echo/turbo spin echo (FSE/TSE) sequences are routinely used for ankle joint imaging. While the 2D sequences provide a good signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) with high spatial resolution, there are some limitations to their use owing to the thick slices, interslice gaps leading to partial volume effects, limited fluid contrast, and the need to acquire separate images in different orthogonal planes. The 3D MR imaging can overcome these limitations and recent advances have led to technical improvements that enable its widespread clinical use in acceptable time periods. The volume imaging renders the advantage of reconstructing into thin continuous slices with isotropic voxels enabling multiplanar reconstructions that helps in visualizing complex anatomy of the structure of interest throughout their course with improved sharpness, definition of anatomic variants, and fluid conspicuity of lesions and injuries. Recent advances have also reduced the acquisition time of the 3D datasets making it more efficient than 2D sequences. This article reviews the recent technical developments in the domain 3D MRI, compares imaging with 3D versus 2D sequences, and demonstrates the use-case scenarios with interesting cases, and benefits of 3D MRI in evaluating various ankle joint components and their lesions.
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Affiliation(s)
- Suryansh Bajaj
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Avneesh Chhabra
- Musculoskeletal Radiology Division, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
- Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
- Johns Hopkins University, Baltimore, MD, USA
- Walton Center of Neurosciences, Liverpool, UK
- University of Dallas, Richardson, TX, USA
| | - Atul Kumar Taneja
- Musculoskeletal Radiology Division, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
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Chughtai N, Figg JW, Saengchote SA, Amador IE, Khan RT, Chughtai M. Direct Observation of a Single Peroneal Myotendinous Unit Anatomic Variant: A Case Report and Systematic Review. JBJS Case Connect 2023; 13:01709767-202309000-00040. [PMID: 37556576 DOI: 10.2106/jbjs.cc.23.00171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
CASE A 29-year-old woman with acute peroneal tendon subluxation underwent superior retinacular repair. On exposure, a single peroneal myotendinous unit was encountered, as opposed to the usual presence of independent peroneal tendons arising from separate muscle bellies. At 3-year follow-up, she has had no recurrence with full return to activity and no limitations. CONCLUSION Multiple peroneal myotendinous variants have been described; however, this report is the first to describe direct intraoperative observation of a single peroneal myotendinous unit. Whether this anatomic variant contributed to the patient's problem or has other potential clinical sequelae remains to be elucidated.
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Affiliation(s)
- Noor Chughtai
- College of Humanities and Sciences, Virginia Commonwealth University, Richmond, Virginia
- Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Orthopaedic and Rheumatologic Institute, Cleveland, Ohio
| | - John W Figg
- Orthopaedic and Sports Medicine Institute, Department of Orthopaedic Surgery, University of Florida, College of Medicine, Gainesville, Florida
| | - Supreeya A Saengchote
- Orthopaedic and Sports Medicine Institute, Department of Orthopaedic Surgery, University of Florida, College of Medicine, Gainesville, Florida
| | - Isabella E Amador
- Orthopaedic and Sports Medicine Institute, Department of Orthopaedic Surgery, University of Florida, College of Medicine, Gainesville, Florida
| | - Reha T Khan
- College of Humanities and Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Morad Chughtai
- Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Orthopaedic and Rheumatologic Institute, Cleveland, Ohio
- Orthopaedic and Sports Medicine Institute, Department of Orthopaedic Surgery, University of Florida, College of Medicine, Gainesville, Florida
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Howard A, John A, Theiss R. Peroneus Tendon Disorders: Evaluation and Non-operative Management. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2023. [DOI: 10.1007/s40141-023-00387-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023]
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Huuskonen M, Borkmann S, Bengtsson A, Sobecki P, Józwiak R, Solidakis N, Szaro P. Radiological features accompanying peroneus brevis split rupture revealed on magnetic resonance imaging - a cohort study. J Foot Ankle Res 2023; 16:10. [PMID: 36864523 PMCID: PMC9979459 DOI: 10.1186/s13047-023-00604-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/01/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Peroneal split tears are an underrated cause of ankle pain. While magnetic resonance imaging (MRI) is useful for diagnosis, split tears are challenging to identify. The aim of the study was to investigate the association of peroneus brevis split rupture with abnormalities of the superior peroneal retinaculum (SPR), anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), joint effusion, morphology of the malleolar groove, presence of the bone marrow oedema and prominent peroneal tuberculum. METHODS Ankle MRI cases were assessed by independent observers retrospectively in two groups: one with peroneus brevis split tears (n = 80) and one without (control group, n = 115). Two observers evaluated the soft tissue lesions, and three graded the bone lesions. Fisher's exact test and Pearson correlation were used for analysis. The Bonferroni-Holm method (B-H) was used to adjust for multiple comparisons. RESULTS Only bone marrow edema in the posterior part of the lateral malleolus was significantly (p < 0.05) more common in the split tear group after applying B-H. SPR total rupture was seen only in the experimental group. No differences in incidence of ATFL and CFL lesions or other SPR lesions were noticed (p < 0.05). CONCLUSION Bone marrow edema in the posterior part of the lateral malleolus is associated with peroneus split tears on MRI.
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Affiliation(s)
- Michael Huuskonen
- grid.8761.80000 0000 9919 9582Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ,grid.1649.a000000009445082XDepartment of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Simon Borkmann
- grid.1649.a000000009445082XDepartment of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Alexander Bengtsson
- grid.1649.a000000009445082XDepartment of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Piotr Sobecki
- grid.426232.30000 0001 2228 7645Applied Artificial Intelligence Laboratory, National Information Processing Institute, Warsaw, Poland
| | - Rafał Józwiak
- grid.426232.30000 0001 2228 7645Applied Artificial Intelligence Laboratory, National Information Processing Institute, Warsaw, Poland ,grid.1035.70000000099214842Faculty of Mathematics and Information Science, Warsaw University of Technology, Warsaw, Poland
| | - Nektarios Solidakis
- grid.8761.80000 0000 9919 9582Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ,grid.1649.a000000009445082XDepartment of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Paweł Szaro
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden. .,Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland.
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Smith PE, Morey M, McManus LJ, Kong A. Magnetic resonance imaging of the ankle: Pathology of the lateral and posterior compartments. J Med Imaging Radiat Oncol 2023. [PMID: 36726341 DOI: 10.1111/1754-9485.13512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/17/2023] [Indexed: 02/03/2023]
Abstract
Magnetic resonance imaging (MRI) is the gold standard for imaging the tendons and the ligaments of the ankle. MRI combines excellent tissue contrast and accurate anatomic delineation of joint structures. In the first article of this series, we discussed a compartmental approach to the interpretation of ankle pathology focusing on the anterior and medial compartments. This article will complete the MR review of the ankle, with a focus on the lateral and posterior compartments of the ankle.
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Affiliation(s)
| | - Matthew Morey
- Epworth Medical Imaging (Geelong), Geelong, Victoria, Australia
| | | | - Andrew Kong
- Regional Imaging (Albury), Albury, New South Wales, Australia
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Morimoto M, Yamaguchi S, Kimura S, Mikami Y, Nakajima H, Watanabe S, Sasho T, Ohtori S. Peroneus brevis tear caused by an impingement between hypertrophied peroneal tubercle and lateral malleolus. Radiol Case Rep 2023; 18:1418-1422. [PMID: 36798063 PMCID: PMC9925843 DOI: 10.1016/j.radcr.2023.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/05/2023] [Accepted: 01/07/2023] [Indexed: 02/04/2023] Open
Abstract
We report a 15-year-old female patient who sustained peroneus brevis injury caused by an impingement between the hypertrophied peroneal tubercle and lateral malleolus. The patient had pain for 3 years in the lateral side of her left ankle with unsuccessful conservative treatment. The oblique sagittal images of 3-dimensional magnetic resonance imaging and ultrasonography were useful in depicting the peroneus brevis injury and identifying the location of impingement between the hypertrophied peroneal tubercle and the tip of the lateral malleolus. The flatfoot deformity of the patient further aggravated the impingement. The patient was treated surgically, with excision of the enlarged tubercle and tendon repair. The ankle pain resolved 12 months postoperatively. Although rare, clinicians should recognize this condition as the cause of lateral ankle pain.
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Affiliation(s)
- Miki Morimoto
- Department of Orthopaedic surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Satoshi Yamaguchi
- Department of Orthopaedic surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan,Graduate School of Global and Transdisciplinary Studies, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba 263-8522, Japan,Corresponding author.
| | - Seji Kimura
- Department of Orthopaedic surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Yukio Mikami
- Department of Orthopaedic surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Hirofumi Nakajima
- Department of Orthopaedic surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Shotaro Watanabe
- Department of Orthopaedic surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
| | - Takahisa Sasho
- Department of Orthopaedic surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan,Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba 263-8522, Japan
| | - Seiji Ohtori
- Department of Orthopaedic surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan
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Ayanoglu T, Arikan E, Kurtbogan M, Yilmaz OF, Kaya YE, Ozturan KE. Anatomical Factors Which Influence the Formation of Peroneal Tendon Tears: A Retrospective Comparative Study. J Foot Ankle Surg 2022; 61:1299-1302. [PMID: 35606277 DOI: 10.1053/j.jfas.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 02/03/2023]
Abstract
This study aims to investigate the anatomical factors that are effective in the formation of peroneal tendon tears comparing with the control group. The patients with ankle magnetic resonance imaging (MRI) due to pain on the lateral side of the ankle were retrospectively analyzed using the clinical archive between July 2015 and January 2020. Peroneal tendon tears, peroneal tubercle type and size, presence of peroneal quartus, presence and type of retromalleolar groove, retromalleolar groove area, lateral malleolus type, presence of os peroneum, peroneus brevis-lateral malleolus distance (PBLMD), and accompanying pathologies in coronal, axial, and sagittal planes MRI were evaluated. PBLMD was measured as 27.1 ± 12.3 mm in Group 1. With PBLMD, it was measured as 39.6 ± 11.68 mm in Group 2. There was a significant relationship between low-lying peroneus brevis muscle and peroneal tear (p < .001). Peroneal tendon tear was more common in patients with peroneal quartus muscle (p < .001). There was a relationship between the retromalleolar groove type and the presence of peroneal tear (p = .004). More peroneal tears were observed in the concave retromalleolar groove type. The presence of concave type retromalleolar groove, peroneus quartus, and low-lying peroneus brevis muscle was found to be associated with peroneal tendon tears.
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Affiliation(s)
- Tacettin Ayanoglu
- Department of Orthopaedics and Traumatology, Abant Izzet Baysal University, Bolu, Turkey
| | - Emre Arikan
- Department of Orthopaedics and Traumatology, Çanakkale State Hospital, Çanakkale, Turkey.
| | - Mahmut Kurtbogan
- Department of Orthopaedics and Traumatology, Abant Izzet Baysal University, Bolu, Turkey
| | - Omer Faruk Yilmaz
- Department of Orthopaedics and Traumatology, Abant Izzet Baysal University, Bolu, Turkey
| | - Yasin Emre Kaya
- Department of Orthopaedics and Traumatology, Abant Izzet Baysal University, Bolu, Turkey
| | - Kutay Engin Ozturan
- Department of Orthopaedics and Traumatology, Abant Izzet Baysal University, Bolu, Turkey
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Fritz B, Fritz J, Sutter R. 3D MRI of the Ankle: A Concise State-of-the-Art Review. Semin Musculoskelet Radiol 2021; 25:514-526. [PMID: 34547816 DOI: 10.1055/s-0041-1731332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Magnetic resonance imaging (MRI) is a powerful imaging modality for visualizing a wide range of ankle disorders that affect ligaments, tendons, and articular cartilage. Standard two-dimensional (2D) fast spin-echo (FSE) and turbo spin-echo (TSE) pulse sequences offer high signal-to-noise and contrast-to-noise ratios, but slice thickness limitations create partial volume effects. Modern three-dimensional (3D) FSE/TSE pulse sequences with isotropic voxel dimensions can achieve higher spatial resolution and similar contrast resolutions in ≤ 5 minutes of acquisition time. Advanced acceleration schemes have reduced the blurring effects of 3D FSE/TSE pulse sequences by affording shorter echo train lengths. The ability for thin-slice partitions and multiplanar reformation capabilities eliminate relevant partial volume effects and render modern 3D FSE/TSE pulse sequences excellently suited for MRI visualization of several oblique and curved structures around the ankle. Clinical efficiency gains can be achieved by replacing two or three 2D FSE/TSE sequences within an ankle protocol with a single isotropic 3D FSE/TSE pulse sequence. In this article, we review technical pulse sequence properties for 3D MRI of the ankle, discuss practical considerations for clinical implementation and achieving the highest image quality, compare diagnostic performance metrics of 2D and 3D MRI for major ankle structures, and illustrate a broad spectrum of ankle abnormalities.
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Affiliation(s)
- Benjamin Fritz
- Department of Radiology, University Hospital Balgrist, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Jan Fritz
- New York University Grossman School of Medicine, New York University, New York, New York
| | - Reto Sutter
- Department of Radiology, University Hospital Balgrist, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Drakonaki EE, Gataa KG, Solidakis N, Szaro P. Anatomical variations and interconnections of the superior peroneal retinaculum to adjacent lateral ankle structures: a preliminary imaging anatomy study. J Ultrason 2021; 21:12-21. [PMID: 33791112 PMCID: PMC8008200 DOI: 10.15557/jou.2021.0003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/04/2021] [Indexed: 12/28/2022] Open
Abstract
Aim This imaging anatomy study aimed at detecting anatomical variations and potential interconnections of the superior peroneal retinaculum to other lateral stabilizing structures. Materials and methods We retrospectively reviewed the imaging archives of 63 patients (38 females, 25 males, mean age 32.7, range 18–58 years) with available ankle US, MR and CT images to detect whether US and MR can detect the presence of interconnections between the superior peroneal retinaculum and the anterior talofibular ligament, inferior extensor retinaculum and peroneal tendon sheath. We evaluated the presence of common anatomical variations including low peroneus brevis muscle belly, peroneal tubercle, os peroneum, and retromalleolar fibular groove shape in relation to the presence of superior peroneal retinaculum connections. Results The connections of the superior peroneal retinaculum can be revealed on magnetic resonance imaging (MRI) and ultrasound (US). The connection to the anterior talofibular ligament was located (a) inferior to the lateral malleolus, (b) at the level of the lateral malleolus and (c) on both levels, respectively (a) 49.2% on MRI and 39.7% on US, p <0.05, (b) 44.4% and 58.7%, p <0.05, 36.5% and (c) 27%, p <0.05. Superior peroneal retinaculum–inferior extensor retinaculum (MRI 47.6%, US 28.6% p <0.001) and superior peroneal retinaculum–peroneal tendon sheath (MRI 22.2%, US 25.4% p >0.05) connections were also found both on MR and US. Conclusion Ankle US and MR revealed interconnections between the superior peroneal retinaculum and the anterior talofibular ligament, inferior extensor retinaculum, and superior peroneal retinaculum. Our results are a starting point for further studies on the connections of the superior peroneal retinaculum and the applicability of ultrasound and MRI in assessing their occurrence. Knowledge of the anatomical connections of the superior peroneal retinaculum may help radiologists with the assessment of lateral ankle injuries, and surgeons with treatment planning.
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Affiliation(s)
- Eleni E Drakonaki
- Musculoskeletal Radiology Practice, Heraklion Crete Greece & Medical School, European University of Cyprus, Cyprus
| | - Khaldun Ghali Gataa
- Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Sweden.,Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Nektarios Solidakis
- Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Sweden.,Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Paweł Szaro
- Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Sweden.,Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Department of Clinical and Descriptive Anatomy, Medical University of Warsaw, Poland
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