US and MR Imaging of the Extensor Compartment of the Ankle

Abstract

Injuries to the extensor compartment of the ankle are uncommon and often are overlooked or misinterpreted at clinical presentation. Ultrasonography (US) and magnetic resonance (MR) imaging play a critical role in the diagnosis and evaluation of these injuries. US is a dynamic, quick, cost-effective imaging method for assessing ankle extensor compartment injuries as an alternative or adjunct to MR imaging. MR imaging provides multiplanar cross-sectional delineation of regional anatomic structures and also can be used to assess the predisposing cause, estimate the extent of injury, and aid in preoperative planning for requisite surgical repair. The spectrum of pathologic conditions affecting the ankle extensor compartment ranges from tendinosis secondary to degenerative, inflammatory, or depositional disease to traumatic tendon or retinacular rupture and entrapment neuropathy. Major components of the ankle extensor compartment at risk for injury include the anterior tibial, extensor hallucis longus, and extensor digitorum longus tendons; the extensor retinacular mechanism; and the anterior tarsal tunnel. Familiarity with the normal anatomic appearance and pathologic features of the ankle extensor compartment at US and MR imaging as well as potential imaging pitfalls is critical for accurate injury evaluation.

A cadaveric study of the morphology of the extensor hallucis longus - a proposal for a new classification

“…Ankle extensor compartment trauma is commonly overlooked yet requires expeditious diagnosis and treatment in order to preserve function and provide positive outcomes. All components of the ankle extensor compartment are susceptible to injury, but the tendons are most frequently injured [22]. Of the different types of EHL lesions, one of the most typical is closed tendon ruptures, which are caused by active tendon contraction against resistance [23, 24].…”

Design of a Bioreactor to Assess the Effect of Passive Joint Loading in a Live Chick Embryo In Ovo

“…21 Importantly, these tendons have been shown to experience strain during plantarflexion. [22][23][24] The ability of this bioreactor to apply passive plantarflexion at different frequencies and durations can facilitate studies of the effects of mechanical loading on development of these tendons. With minor modifications, our bioreactor could also be used to investigate how loading affects development of the knee and other joints.…”

Ultrasound of the Distal Insertions of the Ankle and Foot Tendons with Anatomical Correlation: A Review

“…The extensor hallucis longus is a thin muscle arising from the anterior surface of the fibula and the interosseous membrane. The extensor hallucis longus inserts onto the dorsal surface of the base of the distal phalanx of the hallux and is a powerful dorsiflexor of the great toe (Figures 4 and 5) [3],[4]. In case of a tear, loss of dorsiflexion is observed.…”

“…The extensor digitorum longus arises from the lateral condyle of the tibia, the anterior surface of the fibula, and the interosseous membrane. At the level of the ankle, the muscle passes under the prominent extensor retinacula and divides in 4 tendons coursing over the dorsal aspect of the foot [1],[4]. At the level of the metatarsophalangeal joint, the tendons to the second through fourth toes are joined by the extensor digitorum brevis tendons (Figure 9).…”

“…The peroneus tertius is also known as fibularis tertius [4]. The muscle arises from the lower third of the anterior aspect of the fibula and the interosseous membrane.…”