Imaging of the Tibialis Anterior - Anatomy and Pathologic processes

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2016

Poster Number:

C-1662

Type:

Educational Exhibit

Keywords:

Trauma, Congenital, Athletic injuries, Normal variants, Education, Diagnostic procedure, Ultrasound-Colour Doppler, MR, CT, Musculoskeletal system, Musculoskeletal soft tissue, Extremities

Authors:

C. Bilreiro, C. Carneiro, J. Saraiva, A. R. R. G. Costa, M. O. E. Castro; Portimão/PT

DOI:

10.1594/ecr2016/C-1662

DOI-Link:

https://dx.doi.org/10.1594/ecr2016/C-1662

Fig. 3: Ultrasound evaluation of tibialis anterior hernia (arrows), through a weakness...

Fig. 4: Upper images - T1 (left) and PD fatsat (right) weighted images in the lower...

Fig. 2: MR image PD weighted with fat saturation just above the ankle showing normal...

Learning objectives

To review the imaging aspects of the tibialis anterior muscle and tendon, focusing on: - Normal anatomy; - Muscle disorders; - Tendon abdormalities; - Bursal pathology.

Background

The tibialis anterior muscle and tendon are a frequent source of pathology, especially in the setting of trauma, usually caused by athletic injuries, most frequently muscle calcifications, tears, herniation, atrophy, as well as tendinopathy, tenosynovitis and bursitis. It may also be affected by several systemic conditions, with consequent morphological changes. Congenital conditions and local neoplasms, although infrequent, may also be the cause of pathological changes. Clinical evaluation alone is frequently not conclusive, and using the available imaging modalities (ultrasound, computorized tomography and magnetic resonance), the...

Findings and procedure details

Anatomy Tibialis anterior muscle The tibialis anterior muscle is part of the extensor (anterior) compartment of the leg, arising in the lateral condyle of the tibia, proximal lateral tibial shaft, anterior surface of the interosseous membrane, deep surface of the fascia cruris and intermuscular septum [1]. Its functions are dorsiflexion, adduction and inversion of the foot. It is innervated by the deep peroneal nerve. Tibialis anterior tendon The tibialis anterior tendon Fig. 1 Fig. 2 courses inferiorly and inserts with two bands of variable width...

Conclusion

The tibialis anterior muscle and tendon and the respective subtendinous bursa are a source of varied pathology, which may be of congenital, traumatic, inflammatory and neoplastic etiology. The clinical history and physical evaluation are important, but frequently inconclusive. Therefore, imaging studies are crucial for a correct diagnosis.

Personal information

References

1 - Standring S, et al. Grays anatomy, 40th ed, 2008. Churchill Livingstone Elsevier, New York, p 1417. 2 - Saraffian SK, Kelikian AS. Anatomy of the foot and ankle: descriptive, topographic, functional. 2011. Lippincott, Philadelphia, p 292. 3 - Lee MH, Chung CB, Cho JH, Mohana-Borges AV, Pretterklieber ML, Trudell DJ, Resnick D. Tibialis anterior tendon and extensor retinaculum: imaging in cadavers and patients with tendon tear. AJR. 2006, 187(2):W161. 4 - Varghese A, Bianchi S. Ultrasound of tibialis anterior muscle and tendon -...