Ultrasound-guided Interventions in the Foot and Ankle

ABSTRACT

Both chronic as well as acute foot and ankle pain are common indications for visits to general practitioners, rheumatologists, and orthopedic surgeons. The causes for foot and ankle pain are varied and can include osseous pathology (fractures), yet the far greater majority are secondary to soft-tissue injuries and inflammation. Regional corticosteroid injections, traditionally performed using anatomic landmarks, can be inaccurate and miss intended targets. The use of ultrasound for guidance for interventional radiologic procedures is well known, including guidance for vascular as well as visceral interventions. Using sonography to guide for interventions in the musculoskeletal system, specifically the foot and ankle, yields accurate placement of the needle tip and subsequent anesthetic/steroid injection as well as diagnostic aspiration of tendon sheaths, joint spaces, and bursae.

KEYWORDS

Ultrasonography - foot - ankle

REFERENCES

• 1 Sofka C M, Collins A J, Adler R S. Use of ultrasonographic guidance in interventional musculoskeletal procedures: a review from a single institution.  J Ultrasound Med . 2001;  20 21-26
• 2 Christensen R A, van Sonnenberg E, Casola G, Wittich G R. Interventional ultrasound in the musculoskeletal system.  Radiol Clin North Am . 1988;  26 145-155
• 3 Lin J, Jacobson J A, Fessell D P, Weadock W J, Hayes C W. An illustrated tutorial of musculoskeletal sonography: part 4; musculoskeletal masses, sonographically guided interventions, and miscellaneous topics.  AJR Am J Roentengen . 2000;  175 1711-1119
• 4 Cardinal E, Chhem R K, Beauregard C G. Ultrasound-guided interventional procedures in the musculoskeletal system.  Radiol Clin North Am . 1998;  36 597-604
• 5 van Holsbeeck M, Introcaso J H. Musculoskeletal ultrasonography.  Radiol Clin North Am . 1992;  30 907-925
• 6 Read J W. Musculoskeletal ultrasound: basic principles.  Sem Musc Rad . 1998;  2 203-210
• 7 Balasubramaniam P, Prathap K. The effect of injection of hydrocortisone into rabbit calcaneal tendons.  Br J Bone Joint Surg . 1972;  54B 729-734
• 8 Wang S, Chhem R K, Cardinal E, Cho K H. Joint sonography.  Radiol Clin North Am . 1999;  37 653-668
• 9 Lin J, Fessell D P, Jacobson J A, Weadock W J, Hayes C W. An illustrated tutorial of musculoskeletal sonography: part 3; lower extremity.  AJR Am J Roentengen . 2000;  175 1313-1321
• 10 Fessell D P, van Holsbeeck M. Foot and ankle sonography.  Radiol Clin North Am . 1999;  37 831-858
• 11 Fessell D P, Jacobson J A, Craig J. Using sonography to reveal and aspirate joint effusions.  Am J Roentgenol . 2000;  174 1353-1362
• 12 Khoury N J, El-Khoury G Y, Saltzman C L, Brandser E A. Intra-articular foot and ankle injections to identify source of pain before arthrodesis.  AJR Am J Roentengen . 1996;  167 669-673
• 13 Bureau N J, Ali S S, Chhem R K, Cardinal E. Ultrasound of musculoskeletal infections.  Sem Musc Rad . 1998;  2 299-306
• 14 Craig J G. Infection: ultrasound-guided procedures.  Radiol Clin North Am . 1999;  37 669-678
• 15 Chhem R K, Kaplan P A, Dussault R G. Ultrasonography of the musculoskeletal system.  Radiol Clin North Am . 1994;  32 275-289
• 16 Bureau N J, Chhem R K, Cardinal E. Musculoskeletal infections: ultrasound manifestations.  Radiographics . 1999;  19 1585-1592
• 17 Fessell D P, van Holsbeeck M. Ultrasound of the foot and ankle.  Sem Musc Rad . 1998;  2 271-281
• 18 Gibbon W W, Long G. Ultrasound of the plantar aponeurosis (fascia).  Skeletal Radiol . 1999;  28 21-26
• 19 Acevedo J I, Beskin J L. Complications of plantar fascia rupture associated with corticosteroid injection.  Foot Ankle Int . 1998;  19 91-97
• 20 Sellman J R. Plantar fascia rupture associated with corticosteroid injection.  Foot Ankle Int . 1994;  15 376-381
• 21 Martinoli C, Bianchi S, Derchi L E. Tendon and nerve sonography.  Radiol Clin North Am . 1999;  37 691-711
• 22 Newman J S, Adler R S. Power Doppler sonography: applications in musculoskeletal imaging.  Sem Musc Rad . 1998;  2 331-339
• 23 Murphy K J, Rubin J M. Power Doppler: it's a good thing.  Sem Ultrasound CT MRI . 1997;  18 13-21
• 24 Newman J S, Adler R S, Bude R O, Rubin J M. Detection of soft-tissue hyperemia: value of power Doppler sonography.  AJR Am J Roentengen . 1994;  163 385-389
• 25 Breidahl W H, Newman J S, Taljanovic M S, Adler R S. Power Doppler sonography in the assessment of musculoskeletal fluid collections.  AJR Am J Roentengen . 1996;  166 1443-1446
• 26 Breidahl W H, Stafford Johnson B D, Newman J S, Adler R S. Power Doppler sonography in tenosynovitis: significance of the peritendinous hypoechoic rim.  J Ultrasound Med . 1998;  17 103-107
• 27 Breidahl W H, Adler R S. Ultrasound-guided injection of ganglia with corticosteroids.  Skeletal Radiol . 1996;  25 635-638
• 28 Schlager D. Ultrasound detection of foreign bodies and procedure guidance.  Emer Med Clin NA . 1997;  15 895-912
• 29 Banerjee B, Das R K. Sonographic detection of foreign bodies of the extremities.  Br J Radiol . 1991;  64 107-112
• 30 Blankstein A, Cohen I, Heiman Z, Salai M, Heim M, Chechick A. Localization, detection, and guided removal of soft-tissue foreign bodies in the hands using sonography.  Arch Orthop Trauma Surg . 2000;  120 514-517
• 31 Quinn T J, Jacobson J A, Craig J G, van Holsbeeck T M. Sonography of Morton's neuromas.  AJR Am J Roentengen . 2000;  174 1723-1728