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Pirri C, Stecco C, Güvener O, Mezian K, Ricci V, Jačisko J, Fojtik P, Kara M, Chang KV, Dughbaj M, Özçakar L. EURO-MUSCULUS/USPRM Dynamic Ultrasound Protocols for Ankle/Foot. Am J Phys Med Rehabil 2024; 103:e29-e34. [PMID: 37903600 DOI: 10.1097/phm.0000000000002349] [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: 11/01/2023]
Abstract
ABSTRACT In this dynamic scanning protocol, ultrasound examination of the ankle is described using various maneuvers to assess different conditions. Real-time patient examination and scanning videos are used for better simulation of daily clinical practice. The protocol is prepared by several/international experts in the field of musculoskeletal ultrasound and within the umbrella of European Musculoskeletal Ultrasound Study Group in Physical and Rehabilitation Medicine/Ultrasound Study Group of the International Society of Physical and Rehabilitation Medicine.
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Affiliation(s)
- Carmelo Pirri
- From the Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy (CP, CS); Department of Physical and Rehabilitation Medicine, Mersin University Medical School, Mersin, Turkey (OG); Department of Rehabilitation Medicine, Charles University, First Faculty of Medicine, Prague, Czech Republic (KM); Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy (VR); Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic (JJ); Institute of Anatomy, Charles University, First Faculty of Medicine, Prague, Czech Republic, Department of Orthopedics, The Central Military Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic (PF); Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (MK, L Ö); Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taiwan (K.-VC); National Taiwan University College of Medicine, Taipei, Taiwan (K.-VC); Physical Medicine and Rehabilitation Hospital, Ministry of Health, Kuwait (MD)
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Ruiz Santiago F, Moraleda Cabrera B, Láinez Ramos-Bossini AJ. Ultrasound guided injections in ankle and foot. J Ultrasound 2024; 27:153-159. [PMID: 37518823 PMCID: PMC10908885 DOI: 10.1007/s40477-023-00808-1] [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: 04/02/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
Ultrasound guidance is particularly useful for percutaneous injections in the diagnosis and management of painful conditions of the ankle and foot. The injectates used include steroids and local anesthetics, such as lidocaine, mepivacaine, bupivacaine, ropivacaine, and platelet-rich plasma. Osteoarthritis is the main indication for joint injections. Joints amenable to being injected include the tibiotalar, subtalar, midtarsal, and metatarsophalangeal joints. Tendon injections mainly involve the Achilles, peroneus, extensors, and tibialis tendons, while plantar fascia injections are useful for treating plantar fasciitis and plantar fibromatosis. Forefoot injections include joint arthritis, intermetatarsal bursitis, and Morton neuroma. The standardized approaches and doses reviewed in this paper are based on the authors' experience and can lead to high success in symptomatic relief for various conditions. These injections can be curative or serve as a guide to identify the source of pain when surgery or other therapeutic options are planned.
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Affiliation(s)
- Fernando Ruiz Santiago
- Department of Radiology and Physical Medicine, Faculty of Medicine, University of Granada, 18071, Granada, Spain.
- Musculoskeletal Radiology Unit, Hospital Universitario Virgen de Las Nieves, 18014, Granada, Spain.
- Instituto de Investigación Biosanitaria ibs. Granada, 18012, Granada, Spain.
- , C-Julio Verne 8, 7 B, 18003, Granada, Spain.
| | - Beatriz Moraleda Cabrera
- Musculoskeletal Radiology Unit, Hospital Universitario Virgen de Las Nieves, 18014, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, 18012, Granada, Spain
| | - Antonio Jesús Láinez Ramos-Bossini
- Musculoskeletal Radiology Unit, Hospital Universitario Virgen de Las Nieves, 18014, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, 18012, Granada, Spain
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Reijnierse M, Griffith JF. High-resolution ultrasound and MRI in the evaluation of the forefoot and midfoot. J Ultrason 2023; 23:e251-e271. [PMID: 38020514 PMCID: PMC10668940 DOI: 10.15557/jou.2023.0033] [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: 08/01/2023] [Accepted: 09/28/2023] [Indexed: 12/01/2023] Open
Abstract
Radiography is the appropriate initial imaging modality to assess for midfoot and forefoot pathology before turning to advanced imaging techniques. While most lesions of the mid- and forefoot can be diagnosed clinically, the exact nature and severity of the pathology is often unclear. This review addresses the use of the ultrasound, as well as the added value of magnetic resonance imaging, in diagnosing conditions of the midfoot and forefoot. Ultrasound allows a dynamic assessment as well as enabling imaging-guided interventions for diagnostic and therapeutic purposes. Practical tips for optimal examination of this area with ultrasound and magnetic resonance imaging are provided. Metatarsal stress fracture, Chopart's injury, Lisfranc injury, as well as the 1st metatarsophalangeal joint injury and lesser metatarsophalangeal plantar plate injury are injuries unique to the mid- and forefoot. The imaging anatomy of the 1st and lesser metatarsophalangeal joints is reviewed, as such knowledge is key to correctly assessing injury of these joints. Characteristic imaging features of masses commonly encountered in the mid- and forefoot, such as ganglion cyst, Morton neuroma, gouty tophus, plantar fibroma, foreign body granuloma, and leiomyoma are reviewed. The use of ultrasound and magnetic resonance imaging in assessing degenerative and inflammatory joint disorders, and in particular rheumatoid arthritis, of the mid- and forefoot region is also reviewed. In summary, when necessary, most lesions of the mid-and forefoot can be adequately assessed with ultrasound, supplemented on occasion with radiographs, computed tomography, or magnetic resonance imaging.
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Affiliation(s)
- Monique Reijnierse
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - James F. Griffith
- Department of Imaging & Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong
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Imaging-Guided Musculoskeletal Interventions in the Lower Limb. Radiol Clin North Am 2023; 61:393-404. [PMID: 36739153 DOI: 10.1016/j.rcl.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Imaging guidance is essential for musculoskeletal interventional procedures performed in the lower limb. A strong evidence supports the use of imaging guidance to improve safety, accuracy, and effectiveness of these interventions. Joints, tendons, bursae, and nerves can be effectively approached especially with ultrasound-guided injections. Here, we discuss evidence and technique of the most common image-guided musculoskeletal interventional procedures in the lower limb.
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Ramrattan LA, Masri G, Kaeley GS. Musculoskeletal Ultrasound Diagnosis of Symptomatic Hoffa's Fat Pad Ganglion Cyst Successfully Managed Nonoperatively: A Case Report. Cureus 2021; 13:e18665. [PMID: 34790445 PMCID: PMC8588904 DOI: 10.7759/cureus.18665] [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: 09/14/2021] [Accepted: 10/10/2021] [Indexed: 11/17/2022] Open
Abstract
Ganglion cysts (GCs) can arise from a variety of different areas, but those arising from Hoffa’s fat pad in the knee are relatively rare. A number of different types of cysts are also found in the knee, including meniscus cysts, proximal tibiofibular cysts, and cruciate ligament ganglion cysts. In this case report, a 54-year-old female presented with left knee pain and swelling for eight weeks. In-office musculoskeletal ultrasound (US) was used to diagnose a Hoffa’s fat pad ganglion cyst and aid in targeted steroid injection. The patient was followed up 21 weeks after the injection. She was pain-free, and US findings showed the cyst had significantly decreased in size. This case shows how musculoskeletal ultrasound, a relatively inexpensive diagnostic modality, can be used to accurately diagnose the cause of knee pain, guide an in-office procedure for the treatment of Hoffa's fat pad ganglion cyst, and aid in monitoring.
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Affiliation(s)
- Laurie A Ramrattan
- Department of Medicine/Rheumatology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Ghania Masri
- Department of Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Gurjit S Kaeley
- Department of Medicine/Rheumatology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
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Bagawan A, Nagaraj P, Sahu A. Unusual multiloculated serpiginous ganglion of the foot. J Clin Orthop Trauma 2021; 21:101489. [PMID: 34405086 PMCID: PMC8350405 DOI: 10.1016/j.jcot.2021.101489] [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: 01/08/2021] [Accepted: 06/27/2021] [Indexed: 11/17/2022] Open
Abstract
Ganglions are cystic lesion more commonly seen around the wrist joint. Gangliomas of plantar aspect of the foot are rare. We have presented a case of an unusual serpiginous ganglioma of the plantar aspect of the foot. Less literature is available regarding plantar foot gangliomas. The treatment is challenging because of occurrence of the lesion at weight bearing zone. Available options for treatment includes conservative with splint, intralesional injection,arthroscopic excision and open excision.
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Affiliation(s)
- Arif Bagawan
- Department of Orthopaedics, Ealing Hospital, London, UK
- Corresponding author.
| | | | - Ajay Sahu
- Department of Radiology, Ealing Hospital, London, UK
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Cheng SH, Wang TG. A 51-Year-Old Woman with Right Dorsal Foot Pain. J Med Ultrasound 2019; 27:162-163. [PMID: 31867184 PMCID: PMC6905269 DOI: 10.4103/jmu.jmu_110_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 12/25/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sheng-Hao Cheng
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Hadian Y, Link D, Dahle SE, Isseroff RR. Ultrasound as a diagnostic and interventional aid at point-of-care in dermatology clinic: a case report. J DERMATOL TREAT 2018; 31:74-76. [PMID: 30592244 DOI: 10.1080/09546634.2018.1564231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Ultrasound is currently underutilized in dermatology practice. However, ultrasound provides clinicians with precise and unique information on cutaneous and subcutaneous lesions, while minimizing costs and complications related to more common and invasive diagnostic methods. We report a patient who presented with a tender subcutaneous mass that was diagnosed and treated using point-of-care ultrasound-guidance at the dermatology clinic. Ultrasound revealed features consistent with a ganglion cyst, which was subsequently injected with triamcinolone acetonide under ultrasound-guidance with the resolution of symptoms upon follow-up one month later. Our study demonstrates the utility of ultrasound as an effective, time-efficient diagnostic and interventional aid that can modify dermatology practice.
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Affiliation(s)
- Yasmin Hadian
- Department of Dermatology, School of Medicine, University of California, Davis, CA, USA.,Dermatology Section, VA Northern California Health Care System, Mather, CA, USA
| | - Daniel Link
- Dermatology Section, VA Northern California Health Care System, Mather, CA, USA
| | - Sara E Dahle
- Department of Dermatology, School of Medicine, University of California, Davis, CA, USA.,Podiatry Section, VA Northern California Health Care System, Mather, CA, USA
| | - R Rivkah Isseroff
- Department of Dermatology, School of Medicine, University of California, Davis, CA, USA.,Dermatology Section, VA Northern California Health Care System, Mather, CA, USA
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Abstract
This article is a comprehensive review of the current utilizations of ultrasound in the treatment of orthopedic conditions of the foot and ankle. It reviews the diagnostic and interventional applications to commonly encountered lower-extremity ailments, including plantar fasciosis, tendinosis, and peripheral nerve disorders. It also outlines minimally invasive ultrasound-guided procedures and emerging therapies as alternatives to current treatments. These emerging therapies can be used to assist surgeons and provide options for patients needing intervention. Techniques such as hydrodissection, injection, aspiration, tenotomy, and fasciotomy are discussed, giving readers insight into different treatment modalities and options to help manage their patients.
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Affiliation(s)
- Nahum Michael Beard
- Department of Family Medicine, University of Tennessee Health Science Center, Saint Francis Family Medicine, 1301 Primacy Parkway, Memphis, TN 38119, USA; Department of Orthopaedic Surgery and Biomedical Engineering, 1211 Union Avenue Suite 520, Memphis, TN 38104.
| | - Robert Patrick Gousse
- Department of Orthopaedic Surgery and Biomedical Engineering, 1211 Union Avenue Suite 520, Memphis, TN 38104
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