Learning objectives
To learn proper positioning and normal imaging anatomy in ultrasound evaluation of the forefoot.
To recognize ultrasound findings in various forefoot disorders and understand the role of this technique in their diagnosis.
Background
Forefoot disorders are often associated with metatarsalgia,
which is a common clinical symptom (1).
Since clinical diagnosis is not always straightforward,
imaging evaluation has an essential role in clarifying the clinical scenario (2).
Ultrasound is useful due to the superficial location of most structures.
It allows evaluation of both the soft tissues and early stages of some bony lesions that may not yet be visible on radiographs (2).
Findings and procedure details
This topic is divided in two sections.
The first one will focus on the appropriate positioning of the examinee,
ultrasound technique and normal ultrasound findings,
illustrated with images of the relevant anatomical structures of the forefoot.
The second section will cover ultrasound findings of various forefoot disorders,
showing examples of traumatic,
degenerative and inflammatory processes as well as several non-neoplastic soft tissue masses.
In some cases,
correlation with other imaging techniques will be displayed.
1.
Scanning technique and normal ultrasound examination
The examination should be...
Conclusion
Ultrasound evaluation of the forefoot should be guided according to the complaints of the examinee.
In many cases,
ultrasound allows to reach a diagnosis,
while in others it may suggest the need for correlation with other imaging methods such as radiography or magneticresonance imaging.
Forefoot disorders are a common clinical problem and ultrasound has an important role in their management.
Personal information
Dr.
Rodrigo Curral Monteiro
Radiology Department,
Centro Hospitalar Universitário do Algarve,
Portimão,
Portugal
email:
[email protected]
References
1. Gregg JM,
Schneider T,
Marks P.
MR Imaging and Ultrasound of Metatarsalgia – The Lesser Metatarsals.
Radiol Clin North Am 2008 Nov;46(6):1061-78,
vi-vii.
2. Teh JL,
Disorders of the Ankle and Foot: Forefoot.
In: McNally E,
editor.
Practical musculoskeletal ultrasound.
2nd ed.
Churchill Livingstone/Elsevier; 2014.
p.
315-28.
3. Ashman CJ,
Klecker RJ,
Yu JS.
Forefoot pain involving the metatarsal region: differential diagnosis with MR imaging.
RadioGraphics 2001;21:1425-1440.
4. Bianchi S,
Martinoli C.
Foot.
In: Bianchi S,
Martinoli C,
editors.
Ultrasound of the musculoskeletal system....