Magnetic resonance imaging clinics of North America, 2001
MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnorma... more MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnormalities on MR images depends upon a thorough understanding of the normal anatomy. This article reviews the MR anatomy of the midfoot with cadaveric correlation.
Septic arthritis is a disabling and life-threatening disease that requires early diagnosis for op... more Septic arthritis is a disabling and life-threatening disease that requires early diagnosis for optimal outcome. Although traditionally a clinical and laboratory diagnosis, some patients may be misdiagnosed and referred for magnetic resonance (MR) imaging. Therefore, radiologists need to be aware of the MR imaging findings of septic arthritis, its complications, and diagnostic pitfalls.
Magnetic Resonance Imaging Clinics of North America
MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnorma... more MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnormalities on MR images depends upon a thorough understanding of the normal anatomy. This article reviews the MR anatomy of the midfoot with cadaveric correlation.
he plantar aponeurosis, or plantar fascia, has received considerable attention in the scientific ... more he plantar aponeurosis, or plantar fascia, has received considerable attention in the scientific literature and has been shown to be the most important structure for dynamic longitudinal arch sup- port in the foot (1). The plantar aponeurosis comprises histologically both collagen and elastic fibers arranged in a particular network of bundles and is a tough tendinous (rather than a fascial) layer of the plantar aspect of the foot. This sophisticated combination of fibers, having different biomechanical properties dur- ing stress application to the plantar aponeuro- sis, affords an increased modulus of elasticity during weight bearing (2). Abnormalities affecting the plantar apo- neurosis are well recognized. Patients with suspected abnormality involving the apo- neurosis traditionally have been examined with conventional radiography and bone scintigraphy and occasionally with sonogra- phy. Although conventional radiography re- mains essential in the initial diagnostic approach, MR i...
To determine if passive positioning of the ankle influences the MR imaging appearance of ankle te... more To determine if passive positioning of the ankle influences the MR imaging appearance of ankle tendons and ligaments. A positioning device was used during imaging of 10 volunteers. Axial and coronal T1-weighted images were acquired in six positions of the ankle, and the appearance of the tendons and lateral ligaments was subjectively evaluated. The peroneus longus (PL), peroneus brevis (PB), anterior tibialis (AT), extensor digitorum longus (EDL), and extensor hallucis longus (EHL) tendons were best visualized in 20 degrees of plantarflexion and 20 degrees of inversion (p < 0.0001). The anterior talofibular (ATF) and calcaneofibular (CF) ligaments were best seen in 20 degrees of plantarflexion (p < 0.0001). Ten degrees of dorsiflexion was the least useful imaging plane for all of the aforementioned structures. When there is clinical concern regarding pathology of a specific structure about the ankle, passive positioning may allow optimal evaluation.
The purpose of this work was to demonstrate nerve anatomy of the medial plantar (MP) and lateral ... more The purpose of this work was to demonstrate nerve anatomy of the medial plantar (MP) and lateral plantar (LP) nerves and the first branch of the lateral plantar (FBLP) nerve as depicted with MRI. High resolution MRI of the heel was performed with a standard transmit-receive extremity coil in six human cadaveric specimens using sagittal, axial, and coronal T1-weighted spin echo images. The specimens were then sectioned in the axial and coronal planes. MRI depicted the MP and LP nerves arising from the posterior tibial (PT) nerve. Assessment of the anatomic course and trifurcation of the PT nerve into the plantar nerves and the FBLP nerve was best seen in the sagittal plane. Various portions of these nerves were visualized also in the axial and coronal imaging planes. MRI may demonstrate the origin, course, and branching of nerves in the heel and can provide a means for assessment of the patient presenting with chronic heel pain and suspected entrapment neuropathy.
Osteonecrosis of the patella, although uncommon, has become important to recognize because it can... more Osteonecrosis of the patella, although uncommon, has become important to recognize because it can be a cause of pain in the knee. We describe the imaging manifestations of nontraumatic osteonecrosis of the patella in seven clinical cases. The lesions uniformly involved the superior aspect of the patella. Conventional radiography displayed increased radiodensity, subchondral radiolucent areas, and typical demarcation line surrounding the ischemic region. MR imaging and bone scintigraphy demonstrated the characteristic features of osteonecrosis. Recognition of the imaging findings of osteonecrosis involving the patella can preclude misdiagnosis and may obviate unproductive invasive diagnostic procedures. D
Magnetic Resonance Imaging Clinics of North America
MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnorma... more MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnormalities on MR images depends upon a thorough understanding of the normal anatomy. This article reviews the MR anatomy of the midfoot with cadaveric correlation.
he plantar aponeurosis, or plantar fascia, has received considerable attention in the scientific ... more he plantar aponeurosis, or plantar fascia, has received considerable attention in the scientific literature and has been shown to be the most important structure for dynamic longitudinal arch sup- port in the foot (1). The plantar aponeurosis comprises histologically both collagen and elastic fibers arranged in a particular network of bundles and is a tough tendinous (rather than a fascial) layer of the plantar aspect of the foot. This sophisticated combination of fibers, having different biomechanical properties dur- ing stress application to the plantar aponeuro- sis, affords an increased modulus of elasticity during weight bearing (2). Abnormalities affecting the plantar apo- neurosis are well recognized. Patients with suspected abnormality involving the apo- neurosis traditionally have been examined with conventional radiography and bone scintigraphy and occasionally with sonogra- phy. Although conventional radiography re- mains essential in the initial diagnostic approach, MR i...
Magnetic resonance imaging clinics of North America, 2001
MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnorma... more MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnormalities on MR images depends upon a thorough understanding of the normal anatomy. This article reviews the MR anatomy of the midfoot with cadaveric correlation.
Septic arthritis is a disabling and life-threatening disease that requires early diagnosis for op... more Septic arthritis is a disabling and life-threatening disease that requires early diagnosis for optimal outcome. Although traditionally a clinical and laboratory diagnosis, some patients may be misdiagnosed and referred for magnetic resonance (MR) imaging. Therefore, radiologists need to be aware of the MR imaging findings of septic arthritis, its complications, and diagnostic pitfalls.
Magnetic Resonance Imaging Clinics of North America
MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnorma... more MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnormalities on MR images depends upon a thorough understanding of the normal anatomy. This article reviews the MR anatomy of the midfoot with cadaveric correlation.
he plantar aponeurosis, or plantar fascia, has received considerable attention in the scientific ... more he plantar aponeurosis, or plantar fascia, has received considerable attention in the scientific literature and has been shown to be the most important structure for dynamic longitudinal arch sup- port in the foot (1). The plantar aponeurosis comprises histologically both collagen and elastic fibers arranged in a particular network of bundles and is a tough tendinous (rather than a fascial) layer of the plantar aspect of the foot. This sophisticated combination of fibers, having different biomechanical properties dur- ing stress application to the plantar aponeuro- sis, affords an increased modulus of elasticity during weight bearing (2). Abnormalities affecting the plantar apo- neurosis are well recognized. Patients with suspected abnormality involving the apo- neurosis traditionally have been examined with conventional radiography and bone scintigraphy and occasionally with sonogra- phy. Although conventional radiography re- mains essential in the initial diagnostic approach, MR i...
To determine if passive positioning of the ankle influences the MR imaging appearance of ankle te... more To determine if passive positioning of the ankle influences the MR imaging appearance of ankle tendons and ligaments. A positioning device was used during imaging of 10 volunteers. Axial and coronal T1-weighted images were acquired in six positions of the ankle, and the appearance of the tendons and lateral ligaments was subjectively evaluated. The peroneus longus (PL), peroneus brevis (PB), anterior tibialis (AT), extensor digitorum longus (EDL), and extensor hallucis longus (EHL) tendons were best visualized in 20 degrees of plantarflexion and 20 degrees of inversion (p < 0.0001). The anterior talofibular (ATF) and calcaneofibular (CF) ligaments were best seen in 20 degrees of plantarflexion (p < 0.0001). Ten degrees of dorsiflexion was the least useful imaging plane for all of the aforementioned structures. When there is clinical concern regarding pathology of a specific structure about the ankle, passive positioning may allow optimal evaluation.
The purpose of this work was to demonstrate nerve anatomy of the medial plantar (MP) and lateral ... more The purpose of this work was to demonstrate nerve anatomy of the medial plantar (MP) and lateral plantar (LP) nerves and the first branch of the lateral plantar (FBLP) nerve as depicted with MRI. High resolution MRI of the heel was performed with a standard transmit-receive extremity coil in six human cadaveric specimens using sagittal, axial, and coronal T1-weighted spin echo images. The specimens were then sectioned in the axial and coronal planes. MRI depicted the MP and LP nerves arising from the posterior tibial (PT) nerve. Assessment of the anatomic course and trifurcation of the PT nerve into the plantar nerves and the FBLP nerve was best seen in the sagittal plane. Various portions of these nerves were visualized also in the axial and coronal imaging planes. MRI may demonstrate the origin, course, and branching of nerves in the heel and can provide a means for assessment of the patient presenting with chronic heel pain and suspected entrapment neuropathy.
Osteonecrosis of the patella, although uncommon, has become important to recognize because it can... more Osteonecrosis of the patella, although uncommon, has become important to recognize because it can be a cause of pain in the knee. We describe the imaging manifestations of nontraumatic osteonecrosis of the patella in seven clinical cases. The lesions uniformly involved the superior aspect of the patella. Conventional radiography displayed increased radiodensity, subchondral radiolucent areas, and typical demarcation line surrounding the ischemic region. MR imaging and bone scintigraphy demonstrated the characteristic features of osteonecrosis. Recognition of the imaging findings of osteonecrosis involving the patella can preclude misdiagnosis and may obviate unproductive invasive diagnostic procedures. D
Magnetic Resonance Imaging Clinics of North America
MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnorma... more MR imaging has an invaluable role in the diagnosis of foot and ankle pathology. Analyzing abnormalities on MR images depends upon a thorough understanding of the normal anatomy. This article reviews the MR anatomy of the midfoot with cadaveric correlation.
he plantar aponeurosis, or plantar fascia, has received considerable attention in the scientific ... more he plantar aponeurosis, or plantar fascia, has received considerable attention in the scientific literature and has been shown to be the most important structure for dynamic longitudinal arch sup- port in the foot (1). The plantar aponeurosis comprises histologically both collagen and elastic fibers arranged in a particular network of bundles and is a tough tendinous (rather than a fascial) layer of the plantar aspect of the foot. This sophisticated combination of fibers, having different biomechanical properties dur- ing stress application to the plantar aponeuro- sis, affords an increased modulus of elasticity during weight bearing (2). Abnormalities affecting the plantar apo- neurosis are well recognized. Patients with suspected abnormality involving the apo- neurosis traditionally have been examined with conventional radiography and bone scintigraphy and occasionally with sonogra- phy. Although conventional radiography re- mains essential in the initial diagnostic approach, MR i...
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