Sonographic Diagnosis of Talar Lateral Process Fracture

Abstract

he frequency of fractures of the lateral process of the talus (LPT) has markedly increased because of the expansion of snowboard activity. These lesions are difficult to diagnose, because they have aspecific signs, and standard radiographs do not show the fractures in 50% of cases. Sonography is used more and more in the assessment of ankle trauma, but it is rarely performed for detection of bone fractures. We report a case of a patient in which sonography directly showed an LPT fracture. Case ReportA 32-year-old man was admitted to the Emergency Department for acute right ankle pain that occurred the day before during snowboarding. He had forceful movement of eversion and external rotation of the ankle during a jump landing, followed by inability to bear weight and painful ankle swelling. Clinically, moderate swelling over the lateral malleolar and exquisite inframalleolar local tenderness were evident. Passive inversion and dorsal flexion of the foot were painful. Tests for instability of the ankle joint, including the anterior drawer test, were questionable because of severe pain and reflex muscle activation. Previous routine radiographic findings (anteroposterior [AP] and lateral views) were reported as negative.Because of pain at the external aspect of the ankle, sonography was performed to assess para-articular soft tissues and ligaments. Sonography was performed with commercially available equipment (HDI 5000; Philips Medical Systems, Bothell, WA) working with linear array transducers (frequency band, 5-12 MHz) and no standoff pad. Longitudinal and axial images obtained over the anterior talofibular and calcaneofibular ligaments showed normal aspects of both ligaments and no signs of tears (Fig. 1). A longitudinal image obtained over the

Stress Fractures of the Calcaneus Diagnosed by Sonography: Report of 8 Cases

“…The normal periosteum, depending on its thickness, can sometime difficult to assess by sonography. Due to its tomographic capabilities, sonography can show acute fractures that are difficult to image on radiography and can show a variety of stress fractures . A recent study on sonographic and radiographic capabilities in the early detection of metatarsal stress fractures showed that sonography had sensitivity of 83% and specificity of 76% (correlated with MRI) and that sonography was more sensitive than standard radiography for this purpose …”

Die Fraktur des Processus lateralis tali (Snowboarder's Foot)

“…Copercini et al [6] machten darauf aufmerksam, dass sich der Einsatz der Sonographie sich nicht nur auf die Beurteilung von Ligamenten und Weichteilen beschränke. In Fällen, in denen eine PLT-Fraktur nicht auszuschließen ist, aber eine CT-Aufnahme nicht gemacht werden kann oder will, stellt die Sonographie eine gute und kostengünstige Alternative dar.…”

“…In Fällen, in denen eine PLT-Fraktur nicht auszuschließen ist, aber eine CT-Aufnahme nicht gemacht werden kann oder will, stellt die Sonographie eine gute und kostengünstige Alternative dar. Im Fall des Frakturnachweises ist die CT jedoch nicht ersetzbar [6].…”

Sonographic diagnosis of a medial talar avulsion fracture

“…The talus is the second largest bone of the foot . Anatomically, the talus is divided into the head, neck, and body.…”

“…Fractures of the talus are the second most common site of all tarsal bone fractures . Fractures of the talus may occur at the neck, body, lateral process, talar dome, and posterior process . Fractures of the medial tubercle of the posterior process are relatively rare .…”