Keywords:
Education and training, Education, Ultrasound-Power Doppler, Ultrasound-Colour Doppler, Ultrasound, Neuroradiology peripheral nerve, Musculoskeletal system, Anatomy
Authors:
E. Massone1, A. Muda2, D. Orlandi2, S. Perugin Bernardi2, V. Fichera3, V. Picasso2, G. Rebella1, G. Buonomenna4, M. De Cesari5, E. Silvestri1; 1Genoa/IT, 2Genova/IT, 3Catania/IT, 4Avellino/IT, 5Castelnuovo di Garfagnana/IT
DOI:
10.26044/essr2019/P-0027
Imaging findings OR Procedure Details
US EXAME
Landmarks at the popliteal fossa:
• Popliteal vessels
Landmarks at the leg:
Landmarks at the ankle:
Patient position:
- supine with the foot externally rotated.
Place the probe in a transverse plane,
cranial and posterior to the medial malleolus.
Identify the posterior tibial artery: the round,
hypoechoic,
pulsatile vessel.
Do not put too much pressure on the probe because the vessels are superficial and may be compressed.
Color Doppler can be used to confirm the location of the artery.
The posterior tibial nerve lies posterior to the artery and to the tibialis posterior and flexor digitorum longus tendons.
It appears like a round hyperechoic structure with a typical honeycomb appearance.
(Fig.3).
Move the probe cranially to explore the nerve in the leg: the tibial nerve lies underneath the soleus muscle and superficial to the deep plantarflexor muscles (flexor hallucis longus,
flexor digitorum longus,
and tibialis posterior) (Fig.4) until it merges with the common peroneal nerve in the popliteal fossa (Fig.5).
Move the transducer distally to visualize the bifurcation point of the tibial nerve (located between the abductor hallucis brevis and quadratus plantae muscles) into the medial and lateral plantar nerves (Fig.6).