Skip to main content
SpringerLink
Log in

Imaging of Ankle and Foot Injuries

  • Living reference work entry
  • First Online:
Atlas of Emergency Imaging from Head-to-Toe

  • 205 Accesses

Abstract

The ankle and foot is one of the most frequently injured regions in the body. Injuries in this region may lead to significant long-term morbidity, even despite accurate diagnosis and treatment. Imaging plays a crucial role in the diagnosis and management of ankle and foot injuries. Non-weight-bearing radiography is usually the first step in evaluation of ankle and foot injuries, but weight-bearing or stress imaging of the ankle or foot can help identify subtle injuries. CT is typically reserved for characterizing known fractures of the tibial plafond or posterior foot. However, CT can also be useful for diagnosing radiographically occult fractures. MRI is excellent for identifying injuries to soft tissue structure, but it has a limited role in the acute imaging of foot and ankle injuries due to availability. Ultrasound can also be an excellent modality for identifying soft tissue injuries of the ankle and foot.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Similar content being viewed by others

References

  1. Rui P, Kang K. National Hospital Ambulatory Medical Care Survey: 2017 emergency department summary tables. National Center for Health Statistics. Available from: https://www.cdc.gov/nchs/data/nhamcs/web_tables/2017_ed_web_tables-508.pdf

  2. Lambers K, Ootes D, Ring D. Incidence of patients with lower extremity injuries presenting to US emergency departments by anatomic region, disease category, and age. Clin Orthop Relat Res. 2012;470(1):284–90.

    Article  Google Scholar 

  3. Hermans JJ, Beumer A, De Jong TA, Kleinrensink G. Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach. J Anat. 2010;217(6):633–45.

    Article  Google Scholar 

  4. Peace K, Hillier J, Hulme A, Healy J. MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases. Clin Radiol. 2004;59(11):1025–33.

    Article  CAS  Google Scholar 

  5. Park SS, Kubiak EN, Egol KA, Kummer F, Koval KJ. Stress radiographs after ankle fracture: the effect of ankle position and deltoid ligament status on medial clear space measurements. J Orthop Trauma. 2006;20(1):11–8.

    Article  Google Scholar 

  6. Harper MC. An anatomic and radiographic investigation of the tibiofibular clear space. Foot Ankle. 1993;14(8):455–8.

    Article  CAS  Google Scholar 

  7. Sivakumar BS, An VVG, Oitment C, Myerson M. Subtle lisfranc injuries: a topical review and modification of the classification system. Orthopedics. 2018;41(2):e168–75.

    Article  Google Scholar 

  8. Egol KA, Koval KJ, Zuckerman JD. Handbook of fractures. Lippincott Williams & Wilkins; 2010.

    Google Scholar 

  9. Hetta WM, Niazi G. Concordance of US and MRI for diagnosis of ligamentous and tendinous injuries around the ankle. Egypt J Radiol Nucl Med. 2018;49(1):131–7.

    Article  Google Scholar 

  10. Morvan G, Busson J, Wybier M, Mathieu P. Ultrasound of the ankle. Eur J Ultrasound. 2001;14(1):73–82.

    Article  CAS  Google Scholar 

  11. Horton LK, Jacobson JA, Powell A, Fessell DP, Hayes CW. Sonography and radiography of soft-tissue foreign bodies. AJR Am J Roentgenol. 2001;176(5):1155–9.

    Article  CAS  Google Scholar 

  12. Okanobo H, Khurana B, Sheehan S, Duran-Mendicuti A, Arianjam A, Ledbetter S. Simplified diagnostic algorithm for Lauge-Hansen classification of ankle injuries. Radiographics. 2012;32(2):E71–84.

    Article  Google Scholar 

  13. Greenspan A. Orthopedic imaging: a practical approach. Lippincott Williams & Wilkins; 2014.

    Google Scholar 

  14. Rüedi TP, Allgöwer M. The operative treatment of intra-articular fractures of the lower end of the tibia. Clin Orthop Relat Res. 1979;138:105–10.

    Google Scholar 

  15. Mainwaring BL, Daffner RH, Riemer BL. Pylon fractures of the ankle: a distinct clinical and radiologic entity. Radiology. 1988;168(1):215–8.

    Article  CAS  Google Scholar 

  16. Golshani A, Zhu L, Cai C, Beckmann NM. Incidence and association of CT findings of ankle tendon injuries in patients presenting with ankle and hindfoot fractures. AJR Am J Roentgenol. 2017;208(2):373–9.

    Article  Google Scholar 

  17. Davda K, Malhotra K, O'Donnell P, Singh D, Cullen N. Peroneal tendon disorders. EFORT Open Rev. 2017;2(6):281–92.

    Article  Google Scholar 

  18. Hak DJ, Lin S. Management of talar neck fractures. Orthopedics. 2011;32(9):715–21.

    Article  Google Scholar 

  19. Melenevsky Y, Mackey RA, Abrahams RB, Thomson NB. Talar fractures and dislocations: a radiologist’s guide to timely diagnosis and classification. Radiographics. 2015;35(3):765–79.

    Article  Google Scholar 

  20. Alton T, Patton DJ, Gee AO. Classifications in brief: the hawkins classification for talus fractures. Clin Orthop Relat Res. 2015;473(9):3046–9.

    Article  Google Scholar 

  21. Metzger MJ, Levin JS, Clancy JT. Talar neck fractures and rates of avascular necrosis. J Foot Ankle Surg. 1999;38(2):154–62.

    Article  CAS  Google Scholar 

  22. Badillo K, Pacheco JA, Padua SO, Gomez AA, Colon E, Vidal JA. Multidetector CT evaluation of calcaneal fractures. Radiographics. 2011;31(1):81–92.

    Article  Google Scholar 

  23. Boehler L. Diagnosis, pathology and treatment of fractures of the os calcis. J Bone Joint Surg. 1931;13:75–89.

    Google Scholar 

  24. Gissane W. Discussion on fractures of the os calcis. Proceedings of the British Orthopedic Association. J Bone Joint Surg. 1947;29:254–5.

    Google Scholar 

  25. Knight JR, Gross EA, Bradley GH, Bay C, LoVecchio F. Boehler’s angle and the critical angle of Gissane are of limited use in diagnosing calcaneal fractures in the ED. Am J Emerg Med. 2006;24(4):423–7.

    Article  Google Scholar 

  26. Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993;290:87–95.

    Google Scholar 

  27. Shibuya N, Davis ML, Jupiter DC. Epidemiology of foot and ankle fractures in the United States: an analysis of the National Trauma Data Bank (2007 to 2011). J Foot Ankle Surg. 2014;53(5):606–8.

    Article  Google Scholar 

  28. Siddiqui NA, Galizia MS, Almusa E, Omar IM. Evaluation of the tarsometatarsal joint using conventional radiography, CT, and MR imaging. Radiographics. 2014;34(2):514–31.

    Article  Google Scholar 

  29. Ramadorai MU, Beuchel MW, Sangeorzan BJ. Fractures and dislocations of the tarsal navicular. J Am Acad Orthop Surg. 2016;24(6):379–89.

    Article  Google Scholar 

  30. Mahmoud S, Hamad F, Riaz M, Ahmed G, Al Ateeq M, Ibrahim T. Reliability of the Lisfranc injury radiological classification (Myerson-modified Hardcastle classification system). Int Orthop. 2015;39(11):2215–8.

    Article  Google Scholar 

  31. Cakir H, Van Vliet-Koppert ST, Van Lieshout EM, De Vries MR, Van Der Elst M, Schepers T. Demographics and outcome of metatarsal fractures. Arch Orthop Trauma Surg. 2011;131:241–24.

    Article  CAS  Google Scholar 

  32. Bica D, Sprouse RA, Armen J. Diagnosis and management of common foot fractures. Am Fam Physician. 2016;93(3):183–91.

    PubMed  Google Scholar 

  33. Richli WR, Rosenthal DI. Avulsion fracture of the fifth metatarsal: experimental study of pathomechanics. AJR Am J Roentgenol. 1984;143(4):889–91.

    Article  CAS  Google Scholar 

  34. Gaebler C, Kukla C, Breitenseher MJ, et al. Diagnosis of lateral ankle ligament injuries. Comparison between talar tilt, MRI and operative findings in 112 athletes. Acta Orthop Scand. 1997;68(3):286–90.

    Article  CAS  Google Scholar 

  35. Miller TT. Common tendon and muscle injuries: lower extremity. Ultrasound Clin. 2007;2(4):595–615.

    Article  Google Scholar 

  36. Pedowitz D, Kirwan G. Achilles tendon ruptures. Curr Rev Musculoskelet Med. 2013;6(4):285–93.

    Article  Google Scholar 

  37. Harris G, Harris C. Imaging of tarsal navicular stress injury with a focus on MRI: a pictorial essay. J Med Imaging Radiat Oncol. 2016;60(3):359–64.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. UTHealth – McGovern School of Medicine, Houston, TX, USA

    Joshua Gu, Saagar Patel & Manickam Kumaravel

Authors
  1. Joshua Gu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Saagar Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manickam Kumaravel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Manickam Kumaravel .

Editor information

Editors and Affiliations

  1. Department of Radiology, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada

    Michael N Patlas

  2. Department of Radiology, NYU Winthrop Hospital, Mineola, NY, USA

    Douglas S. Katz

  3. Department of Radiology, Pineta Grande Hospital, Castel Volturno, Italy

    Mariano Scaglione

Section Editor information

  1. University of Texas at Houston, Houston, USA

    Manickam Kumaravel MD

  2. UTHealth- McGovern School of Medicine, Houston, Texas, USA

    Nicholas Beckmann MD

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Gu, J., Patel, S., Kumaravel, M. (2021). Imaging of Ankle and Foot Injuries. In: Patlas, M.N., Katz, D.S., Scaglione, M. (eds) Atlas of Emergency Imaging from Head-to-Toe. Springer, Cham. https://doi.org/10.1007/978-3-030-44092-3_42-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-44092-3_42-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-44092-3

  • Online ISBN: 978-3-030-44092-3

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation