Purpose
The purpose of this educational exhibit is to familiarize the radiologist with the imaging features of variations in the osseous anatomy of ankle and feet and how they can lead to symptoms.
Methods and Materials
From the database of the AZ Jan Portaels (Vilvoorde,
Belgium),
OLV Hospital Aalst-Asse-Ninove (Aalst,
Asse,
and Ninove,
Belgium),
AZ Erica (Mol and Geel,
Belgium),
and AZ Sint-Maarten (Duffel and Mechelen,
Belgium),
we retrospectively reviewed 121 patients,
treated in the 8-year period between 2005 and 2013,
for variations in the osseous anatomy of ankle and foot.
53 of the study patients were male,
68 were female.
In 75 patients,
the same variant occurred bilaterally.
Of almost all ankles and feet,
plain films were at our disposal....
Results
Ossicles are just tiny bones; the term may point to any small bone throughout the body,
i.e.
the auditory ossicles,
or the ossicles of the hands and feet.
In the ankle and foot,
ossicles appear as either accessory centers of ossification,
or sesamoids.
Apart from the os tibiale externum,
which is usually called by its English name — the accessory navicular bone — ossicles are referred to by their Latin names.
On MR,
ossicles generally have a fatty signal.
Accessory centers of ossification are variant...
Conclusion
Imaging plays a pivotal role in the assessment of osseous variants of ankle and feet.
Plain fims are an excellent way of demonstrating osseous variants and their uni- or bilateral occurrence.
CT is often used to assess variants with more complex morphology,
such as coalitions,
and to differentiate ossicles from fractures.
US can evaluate superficial tendons and ligaments,
bursae,
and joint effusions.
Pathology of the bone marrow and superficial as well as deep soft tissues can be well visualized on MR.
MR can also demonstrate...
References
INTRODUCTION
Coskun N,
Yuksel M,
Cevener M et al.
Incidence of accessory ossicles and sesamoid bones in the feet: a radiographic study of the Turkish subjects.
Surgical and radiologic anatomy: SRA 2009; 31: 19-24.
1.
THE OS TRIGONUM AND STIEDA PROCESS
Karasick D,
Schweitzer ME.
The os trigonum syndrome: imaging features.
AJR American journal of roentgenology 1996; 166: 125-9.
Shepherd FJ.
A Hitherto Undescribed Fracture of the Astragalus.
Journal of anatomy and physiology 1882; 17: 79-81.
Lee JC,
Calder JD,
Healy JC.
Posterior impingement syndromes...