Ultrasound-Guided Interventions of the Foot and Ankle

Abstract

Ultrasound (US) provides excellent delineation of tendons and ligaments in the foot and ankle and provides real-time visualization of a needle during interventions, yielding greater accuracy and efficacy than the traditional blind approach using anatomical landmarks. For this reason, US is rapidly gaining acceptance as the preferred modality for guiding interventions in the foot and ankle where the anatomy is complex, neurovascular structures should be identified, and precise technique is demanded. In the foot and ankle, US is especially useful to guide tendon sheath, bursal, and Achilles paratenon injections, Morton neuroma injections, plantar fascial injections, and joint aspirations and injections.

Ankle impingement syndromes: an imaging review

“…Ultrasonography has additionally been evaluated with possible utility in directing diagnostic and therapeutic corticosteroid injection. 5 In addition, ultrasound has the ability to add assistance in diagnosis by utilizing dynamic techniques.…”

“…The aetiology and pathogenesis can be quite varied. In general, the diagnosis of ankle impingement is clinical, with supporting information provided by radiographs and more advanced imaging (CT, MRI and ultrasound), [3][4][5][6] which can help further elucidate the anatomic mechanism of impingement, localize pathology to guide diagnostic and therapeutic injections and assist with presurgical planning.…”

Perspectives in ultrasound-guided musculoskeletal interventions

“…Subtalar joint steroid injections[ 125 126 ] have been attempted for degenerative and inflammatory arthritis and impingement syndromes. Intermetatarsal ganglion cysts[ 125 126 ] can also be aspirated under USG guidance using either a plantar approach or a dorsal approach through the intermetatarsal space. The acromioclavicular joint space is also easily identified and accessible for USG-guided aspirations and steroid injections.…”

US in ankle impingement syndrome

“…Aseptic precautions must be rigorous and include thorough skin disinfection and sterile US probe cover. Contraindications may be local (skin infection) or systemic (coagulation disorders, sepsis, uncontrolled diabetes), but they are rare [29].…”