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Omar IM, Weaver JS, Altbach MI, Herynk BA, McCurdy WE, Kadakia AR, Taljanovic MS. Imaging of osteoarthritis from the ankle through the midfoot. Skeletal Radiol 2023; 52:2239-2257. [PMID: 36737484 PMCID: PMC10400729 DOI: 10.1007/s00256-023-04287-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 02/05/2023]
Abstract
Ankle, hindfoot, and midfoot osteoarthritis (OA) is most commonly posttraumatic and tends to become symptomatic in younger patients. It often results from instability due to insufficiency of supportive soft tissue structures, such as ligaments and tendons. Diagnostic imaging can be helpful to detect and characterize the distribution of OA, and to assess the integrity of these supportive structures, which helps determine prognosis and guide treatment. However, the imaging findings associated with OA and instability may be subtle and unrecognized until the process is advanced, which may ultimately limit therapeutic options to salvage procedures. It is important to understand the abilities and limitations of various imaging modalities used to assess ankle, hindfoot, and midfoot OA, and to be familiar with the imaging findings of OA and instability patterns.
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Affiliation(s)
- Imran M Omar
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 800, Chicago, IL, 60611, USA.
| | - Jennifer S Weaver
- Department of Radiology, Medical Center North, Vanderbilt University Medical Center, 1161 21St Ave. South, Nashville, TN, 37232, USA
| | - Maria I Altbach
- Department of Medical Imaging, University of Arizona College of Medicine Tucson, 1501 North Campbell, P.O. Box 245067, Tucson, AZ, 85724, USA
| | - Bradley A Herynk
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 800, Chicago, IL, 60611, USA
| | - Wendy E McCurdy
- Department of Medical Imaging, University of Arizona College of Medicine Tucson, 1501 North Campbell, P.O. Box 245067, Tucson, AZ, 85724, USA
| | - Anish R Kadakia
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 1350, Chicago, IL, 60611, USA
| | - Mihra S Taljanovic
- Department of Medical Imaging, University of Arizona College of Medicine Tucson, 1501 North Campbell, P.O. Box 245067, Tucson, AZ, 85724, USA
- Department of Orthopaedic Surgery, University of Arizona College of Medicine Tucson, 1501 North Campbell, P.O. Box 245067, Tucson, AZ, 85724, USA
- Department of Radiology, University of New Mexico School of Medicine, 2211 Lomas Boulevard NE, Albuquerque, NM, 87106, USA
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Hegazy MA, Khairy HM, Hegazy AA, Sebaei MAEF, Sadek SI. Talus bone: normal anatomy, anatomical variations and clinical correlations. Anat Sci Int 2023:10.1007/s12565-023-00712-y. [PMID: 37017903 DOI: 10.1007/s12565-023-00712-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/28/2023] [Indexed: 04/06/2023]
Abstract
Talus is a pivotal bone that assists in easy and correct locomotion and transfers body weight from the shin to the foot. Despite its small size, it is implicated in many clinical disorders. Familiarity with the anatomy of the talus and its anatomical variations is essential for the diagnosis of any disorder related to these variations. Furthermore, orthopedic surgeons must be fully aware by this anatomy during podiatry procedures. In this review, we attempt to present its anatomy in a simple, updated and comprehensive manner. We have also added the anatomical variations and some clinical points relevant to the unique and complex anatomy of talus. The talus has no muscle attachment. However, it does have many ligaments attached to it and others around it to keep it in place. Moreover, the bone plays a pig role in movements due to its involvement in many joints. Most of its surface is covered with articular cartilage. Therefore, its blood supply is relatively poor. This puts the talus at greater risk for poor healing as well as more complications in the event of injury than any other bone. We hope this review will make it easier for clinicians to pursue and understand the updated essential knowledge of one of the most complex bone anatomies that they need in their clinical practice.
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Affiliation(s)
| | - Hossam Mohammed Khairy
- Orthopedic Surgery Department, Faculty of Medicine, Zagazig University, Zagazig City, 44519, Egypt
| | - Abdelmonem Awad Hegazy
- Basic Medical Science Department, Faculty of Dentistry, Zarqa University, Zarqa City, 13110, Jordan.
- Human Anatomy and Embryology Department, Faculty of Medicine, Zagazig University, Zagazig City, 44519, Egypt.
| | | | - Sami Ibrahim Sadek
- Orthopedic Surgery Department, Faculty of Medicine, Zagazig University, Zagazig City, 44519, Egypt
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Bachir RM, Zaia IM, Santos GS, Fonseca LFD, Boni G, Guercia RF, Ferreira GF, Lana JFSD. Bone Marrow Aspirate Concentrate Improves Outcomes in Adults With Osteochondral Dissecans of the Talus and Achilles Rupture. Arthroscopy 2023; 39:881-886. [PMID: 36543662 DOI: 10.1016/j.arthro.2022.11.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The objective of this systematic literature review was to investigate the effects of the clinical application of bone marrow aspirate (BMA) and/or bone marrow aspirate concentrate (BMAC) in tendon and cartilage injuries in the foot and ankle. METHODS A search of the Embase, MEDLINE/PubMed, CINAHL, and Cochrane databases was performed in January 2021. The risk of bias of the studies was assessed using the tool "A Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies." The outcomes analyzed included pain reduction and functional improvement with the use of BMA/BMAC in patients with tendon and cartilage injuries in the foot and ankle. RESULTS Eleven studies met the inclusion criteria for analysis, involving a total of 527 subjects with osteochondral lesions (OCLs) of the talus, cartilage lesions of the talus, and acute Achilles tendon rupture. BMAC was applied alone in 4 studies, and in 7 studies, it was compared with other techniques such as matrix-induced autologous chondrocyte implantation, particulate juvenile articular cartilage, or microfracture. Interventions demonstrated improved function and reduced foot and ankle pain and showed no serious adverse effects. CONCLUSIONS Evidence indicates that BMAC provides good clinical results, with improved function and reduced pain in adults with OCL and cartilage lesions of the talus and acute Achilles tendon rupture. LEVEL OF EVIDENCE Level IV, systematic review of level II to IV studies.
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Affiliation(s)
| | | | | | - Lucas Furtado da Fonseca
- Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba, SP, Brazil; Universidade Federal de São Paulo (UNIFESP), São Paulo, SP Brazil
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Iyengar KP, Gregory K, Beale D, Prem H, Gavvala S, Botchu R. Isolated, periosteal stripping injuries of the Flexor Retinaculum: Case series of 3 patients with clinico-radiological review. J Clin Orthop Trauma 2023; 36:102082. [PMID: 36465495 PMCID: PMC9712989 DOI: 10.1016/j.jcot.2022.102082] [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: 04/11/2022] [Revised: 10/03/2022] [Accepted: 11/23/2022] [Indexed: 11/25/2022] Open
Abstract
Isolated periosteal avulsion injuries of the flexor retinaculum on the medial side of the ankle are rare and may mimic osseous injuries or deltoid ligament tears. We describe a case series of 3 individuals with isolated, stripping injuries of the tibial attachment of the flexor retinaculum without underlying fracture or deltoid ligament disruption. A new classification system of flexor retinaculum periosteal stripping injuries of the ankle is proposed with clinico-radiological features.
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Affiliation(s)
| | - K.M. Gregory
- Department of Sport and Exercise Medicine, University Hospitals of Birmingham, Birmingham and University Hospitals of Leicester, UK
| | | | - H. Prem
- Department of Foot and Ankle Surgery, Royal Orthopedic Hospital, Birmingham, UK
| | - S.N. Gavvala
- Department of Radiology, Kurnool Medical College, Kurnool, India
| | - R. Botchu
- Heath Lodge Clinic, Knowle, UK
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
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Idowu B, Afolabi B, Onigbinde S, Ogholoh O, Nwafor N. Magnetic resonance imaging of ankle disorders in adult Nigerians in Lagos. JOURNAL OF WEST AFRICAN COLLEGE OF SURGEONS 2022; 12:81-87. [PMID: 36213798 PMCID: PMC9536414 DOI: 10.4103/jwas.jwas_134_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/20/2022] [Indexed: 11/24/2022]
Abstract
Objectives: The aim of this study was to establish the frequency, distribution, and spectrum of abnormalities on ankle magnetic resonance imaging (MRI) in adult Nigerians. Materials and Methods: A retrospective analysis of ankle MRI of 50 adult patients was conducted at a single health facility. All adult Nigerians with complete clinical data, MRI images, and radiologists’ reports were included. The clinical history and ankle MRI findings were recorded and analysed. The threshold for statistical significance was established at P≤0.05. Results: There were 50 subjects comprising 27 males (54%) and 23 females (46%) aged 25–66 years (mean age = 42.84 ± 9.63 years). The right ankle was evaluated in 27 subjects (54%), while the left ankle was studied in 23 (46%). There was a history of trauma in 40 subjects (80%; 27 right ankles and 13 left ankles). Ankle joint effusion was the most common abnormality—seen in 50% of all subjects and in 62.5% of those with antecedent trauma. Achilles tendinosis and Kager (pre-Achilles) fat pad oedema (8–12%), deltoid ligament tear (8%), and medial malleolar fracture (4%) were the other frequently detected pathologies. The other pathologies detected were posterior tibial tendinosis (2%), plantar fasciopathy (2%), and talar contusion (2%). Joint effusion was significantly more prevalent in post-traumatic ankles than in the non-traumatic ankles and in the right ankles than the left ankles. There was no significant difference in the frequency of ankle abnormalities between the male and female subjects and between subjects younger than and older than the mean age. Conclusion: Joint effusion, deltoid ligament tear, and Achilles tendinopathy were the prevalent derangements in evaluated ankle joints. Trauma was the main indication for ankle MRI in this study.
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Gorbachova T, Melenevsky YV, Latt LD, Weaver JS, Taljanovic MS. Imaging and Treatment of Posttraumatic Ankle and Hindfoot Osteoarthritis. J Clin Med 2021; 10:jcm10245848. [PMID: 34945144 PMCID: PMC8703616 DOI: 10.3390/jcm10245848] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 11/26/2022] Open
Abstract
Posttraumatic osteoarthritis of the ankle and hindfoot is a common and frequently debilitating disorder. 70% to 90% of ankle osteoarthritis is related to prior trauma that encompasses a spectrum of disorders including fractures and ligamentous injuries that either disrupt the articular surface or result in instability of the joint. In addition to clinical evaluation, imaging plays a substantial role in the treatment planning of posttraumatic ankle and hindfoot osteoarthritis. Imaging evaluation must be tailored to specific clinical scenarios and includes weight bearing radiography that utilizes standard and specialty views, computed tomography which can be performed with a standard or a weight bearing technique, magnetic resonance imaging, and ultrasound evaluation. This review article aims to familiarize the reader with treatment rationale, to provide a brief review of surgical techniques and to illustrate expected imaging appearances of common operative procedures performed in the setting of posttraumatic ankle and hindfoot osteoarthritis, such as joint-preserving procedures, ankle fusion, subtalar fusion, tibiotalarcalcaneal fusion and ankle arthroplasty. Preoperative findings will be discussed along with the expected postoperative appearance of various procedures in order to improve detection of their complications on imaging and to provide optimal patient care.
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Affiliation(s)
- Tetyana Gorbachova
- Einstein Medical Center, Department of Radiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19141, USA
- Correspondence:
| | - Yulia V. Melenevsky
- Department of Radiology, UAB Medical Center, University of Alabama at Birmingham, Birmingham, AL 35249, USA;
| | - L. Daniel Latt
- Department of Orthopaedic Surgery, University of Arizona, Tucson, AZ 85724, USA;
| | - Jennifer S. Weaver
- Department of Radiology, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Mihra S. Taljanovic
- Department of Radiology, University of New Mexico Health Sciences, Albuquerque, NM 87131, USA;
- Departments of Medical Imaging and Orthopaedic Surgery, University of Arizona, Tucson, AZ 85724, USA
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