presentation1.pptx. ultrasound examination of the foot
TRANSCRIPT
Ultrasound examination of the foot
Dr ABD ALLAH NAZEER MD
EQUIPMENT SELECTION AND TECHNIQUEUse of a high resolution probe (7-15MHZ) is essential when assessing the superficial structures of the foot Careful scanning technique to avoid anisotropy (and possible misdiagnosis) Beam steering or compounding can help to overcome anisotropy in linear structures such as tendons Good colour power Doppler capabilities when assessing vessels or vascularity of a structure Be prepared to change frequency output of probe (or probes) to adequately assess both superficial and deeper structures
SCANNING TECHNIQUEHIND FOOTPlantar FasciaPatient prone on bed foot flexed with toes on the bed for support Place the probe over the midline of the heel on the plantar aspect The toe of the probe towards the heel The plantar fascia will be seen as a fibrillar structure inserting onto the calcaneum It should be flat and homogenousMID FOOTPlantar FibromatosisThe patient will generally present with on or more palpable thickenings in the arch of their foot Follow the plantar fascia into the arch and look for fusiform nodular thickenings They may be subtle and more numerous than can be palpatedFOREFOOTBegin by scanning each metacarpophalangeal joint for effusions synovial thickenings or ganglia Assess the extensor then flexor aspects
ULTRASOUND OF THE FOOT ndash Normal
Plantar fascia origin scan plane
Normal plantar fascia origin on the calcaneum Tension enthesopaphytes are common here Follow the fibers anteriorly through the arch
Anterior forefoot
Assess the extensor tendons dynamically for pathology Check the underlying joints (with minimal probe pressure) for effusions
The plantar plate is seen arising from the base of the proximal phalanx on the plantar aspect You should gently extend the toe to visualize fullyPlantar plate scan plane
Forefoot scan plane
ULTRASOUND OF THE FOOT PROTOCOLROLE OF ULTRASOUND Ultrasound is used for the soft tissue structures of the footUltrasound is a valuable diagnostic tool in assessing the following indicationsMuscular tendinous and ligamentous damage (chronic and acute)Plantar platesBursitisSoft tissue masses such as ganglia lipomas Mortonrsquos neuromasPlantar fasciaJoint effusionsVascular pathologyHaematomasClassification of a mass eg solid cystic mixedPost surgical complications eg abscess edemaGuidance of injection aspiration or biopsySome bony pathology
A ganglion ganglion cyst or synovial cyst is a swelling filled with
fluid near a joint or tendon such as the ankle foot or fingersThe swelling looks like a smooth soft lump under the skin and can range from pea-sized to being as big as a golf ball in some casesThe swelling contains a jelly-like substance called synovial fluidGanglion cysts do not always cause any pain unless they are next to a nerve The cause of ganglion cysts is not known One theory suggests that trauma causes the tissue of the joint to break down forming small cysts which then join into a larger more obvious mass The most likely theory involves a flaw in the joint capsule or tendon sheath that allows the joint tissue to bulge out
Ganglion symptomsThe ganglion cyst swelling may appear over time or appear suddenly may get smaller in size and may even go away only to come back at another timeGanglions can cause some degree of pain usually following acute or repetitive trauma but many are without symptoms except for appearanceAny pain is usually nonstop aching and made worse by joint motionWhen the ganglion is connected to a tendon there may be a sense of weakness in the affected toe
Multiple images for cysts and ganglia in the forefoot
Multiple images for cysts and ganglia in the forefoot
Foot superficialis hemangiomavenous vascular malformation
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
EQUIPMENT SELECTION AND TECHNIQUEUse of a high resolution probe (7-15MHZ) is essential when assessing the superficial structures of the foot Careful scanning technique to avoid anisotropy (and possible misdiagnosis) Beam steering or compounding can help to overcome anisotropy in linear structures such as tendons Good colour power Doppler capabilities when assessing vessels or vascularity of a structure Be prepared to change frequency output of probe (or probes) to adequately assess both superficial and deeper structures
SCANNING TECHNIQUEHIND FOOTPlantar FasciaPatient prone on bed foot flexed with toes on the bed for support Place the probe over the midline of the heel on the plantar aspect The toe of the probe towards the heel The plantar fascia will be seen as a fibrillar structure inserting onto the calcaneum It should be flat and homogenousMID FOOTPlantar FibromatosisThe patient will generally present with on or more palpable thickenings in the arch of their foot Follow the plantar fascia into the arch and look for fusiform nodular thickenings They may be subtle and more numerous than can be palpatedFOREFOOTBegin by scanning each metacarpophalangeal joint for effusions synovial thickenings or ganglia Assess the extensor then flexor aspects
ULTRASOUND OF THE FOOT ndash Normal
Plantar fascia origin scan plane
Normal plantar fascia origin on the calcaneum Tension enthesopaphytes are common here Follow the fibers anteriorly through the arch
Anterior forefoot
Assess the extensor tendons dynamically for pathology Check the underlying joints (with minimal probe pressure) for effusions
The plantar plate is seen arising from the base of the proximal phalanx on the plantar aspect You should gently extend the toe to visualize fullyPlantar plate scan plane
Forefoot scan plane
ULTRASOUND OF THE FOOT PROTOCOLROLE OF ULTRASOUND Ultrasound is used for the soft tissue structures of the footUltrasound is a valuable diagnostic tool in assessing the following indicationsMuscular tendinous and ligamentous damage (chronic and acute)Plantar platesBursitisSoft tissue masses such as ganglia lipomas Mortonrsquos neuromasPlantar fasciaJoint effusionsVascular pathologyHaematomasClassification of a mass eg solid cystic mixedPost surgical complications eg abscess edemaGuidance of injection aspiration or biopsySome bony pathology
A ganglion ganglion cyst or synovial cyst is a swelling filled with
fluid near a joint or tendon such as the ankle foot or fingersThe swelling looks like a smooth soft lump under the skin and can range from pea-sized to being as big as a golf ball in some casesThe swelling contains a jelly-like substance called synovial fluidGanglion cysts do not always cause any pain unless they are next to a nerve The cause of ganglion cysts is not known One theory suggests that trauma causes the tissue of the joint to break down forming small cysts which then join into a larger more obvious mass The most likely theory involves a flaw in the joint capsule or tendon sheath that allows the joint tissue to bulge out
Ganglion symptomsThe ganglion cyst swelling may appear over time or appear suddenly may get smaller in size and may even go away only to come back at another timeGanglions can cause some degree of pain usually following acute or repetitive trauma but many are without symptoms except for appearanceAny pain is usually nonstop aching and made worse by joint motionWhen the ganglion is connected to a tendon there may be a sense of weakness in the affected toe
Multiple images for cysts and ganglia in the forefoot
Multiple images for cysts and ganglia in the forefoot
Foot superficialis hemangiomavenous vascular malformation
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
ULTRASOUND OF THE FOOT ndash Normal
Plantar fascia origin scan plane
Normal plantar fascia origin on the calcaneum Tension enthesopaphytes are common here Follow the fibers anteriorly through the arch
Anterior forefoot
Assess the extensor tendons dynamically for pathology Check the underlying joints (with minimal probe pressure) for effusions
The plantar plate is seen arising from the base of the proximal phalanx on the plantar aspect You should gently extend the toe to visualize fullyPlantar plate scan plane
Forefoot scan plane
ULTRASOUND OF THE FOOT PROTOCOLROLE OF ULTRASOUND Ultrasound is used for the soft tissue structures of the footUltrasound is a valuable diagnostic tool in assessing the following indicationsMuscular tendinous and ligamentous damage (chronic and acute)Plantar platesBursitisSoft tissue masses such as ganglia lipomas Mortonrsquos neuromasPlantar fasciaJoint effusionsVascular pathologyHaematomasClassification of a mass eg solid cystic mixedPost surgical complications eg abscess edemaGuidance of injection aspiration or biopsySome bony pathology
A ganglion ganglion cyst or synovial cyst is a swelling filled with
fluid near a joint or tendon such as the ankle foot or fingersThe swelling looks like a smooth soft lump under the skin and can range from pea-sized to being as big as a golf ball in some casesThe swelling contains a jelly-like substance called synovial fluidGanglion cysts do not always cause any pain unless they are next to a nerve The cause of ganglion cysts is not known One theory suggests that trauma causes the tissue of the joint to break down forming small cysts which then join into a larger more obvious mass The most likely theory involves a flaw in the joint capsule or tendon sheath that allows the joint tissue to bulge out
Ganglion symptomsThe ganglion cyst swelling may appear over time or appear suddenly may get smaller in size and may even go away only to come back at another timeGanglions can cause some degree of pain usually following acute or repetitive trauma but many are without symptoms except for appearanceAny pain is usually nonstop aching and made worse by joint motionWhen the ganglion is connected to a tendon there may be a sense of weakness in the affected toe
Multiple images for cysts and ganglia in the forefoot
Multiple images for cysts and ganglia in the forefoot
Foot superficialis hemangiomavenous vascular malformation
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Anterior forefoot
Assess the extensor tendons dynamically for pathology Check the underlying joints (with minimal probe pressure) for effusions
The plantar plate is seen arising from the base of the proximal phalanx on the plantar aspect You should gently extend the toe to visualize fullyPlantar plate scan plane
Forefoot scan plane
ULTRASOUND OF THE FOOT PROTOCOLROLE OF ULTRASOUND Ultrasound is used for the soft tissue structures of the footUltrasound is a valuable diagnostic tool in assessing the following indicationsMuscular tendinous and ligamentous damage (chronic and acute)Plantar platesBursitisSoft tissue masses such as ganglia lipomas Mortonrsquos neuromasPlantar fasciaJoint effusionsVascular pathologyHaematomasClassification of a mass eg solid cystic mixedPost surgical complications eg abscess edemaGuidance of injection aspiration or biopsySome bony pathology
A ganglion ganglion cyst or synovial cyst is a swelling filled with
fluid near a joint or tendon such as the ankle foot or fingersThe swelling looks like a smooth soft lump under the skin and can range from pea-sized to being as big as a golf ball in some casesThe swelling contains a jelly-like substance called synovial fluidGanglion cysts do not always cause any pain unless they are next to a nerve The cause of ganglion cysts is not known One theory suggests that trauma causes the tissue of the joint to break down forming small cysts which then join into a larger more obvious mass The most likely theory involves a flaw in the joint capsule or tendon sheath that allows the joint tissue to bulge out
Ganglion symptomsThe ganglion cyst swelling may appear over time or appear suddenly may get smaller in size and may even go away only to come back at another timeGanglions can cause some degree of pain usually following acute or repetitive trauma but many are without symptoms except for appearanceAny pain is usually nonstop aching and made worse by joint motionWhen the ganglion is connected to a tendon there may be a sense of weakness in the affected toe
Multiple images for cysts and ganglia in the forefoot
Multiple images for cysts and ganglia in the forefoot
Foot superficialis hemangiomavenous vascular malformation
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
The plantar plate is seen arising from the base of the proximal phalanx on the plantar aspect You should gently extend the toe to visualize fullyPlantar plate scan plane
Forefoot scan plane
ULTRASOUND OF THE FOOT PROTOCOLROLE OF ULTRASOUND Ultrasound is used for the soft tissue structures of the footUltrasound is a valuable diagnostic tool in assessing the following indicationsMuscular tendinous and ligamentous damage (chronic and acute)Plantar platesBursitisSoft tissue masses such as ganglia lipomas Mortonrsquos neuromasPlantar fasciaJoint effusionsVascular pathologyHaematomasClassification of a mass eg solid cystic mixedPost surgical complications eg abscess edemaGuidance of injection aspiration or biopsySome bony pathology
A ganglion ganglion cyst or synovial cyst is a swelling filled with
fluid near a joint or tendon such as the ankle foot or fingersThe swelling looks like a smooth soft lump under the skin and can range from pea-sized to being as big as a golf ball in some casesThe swelling contains a jelly-like substance called synovial fluidGanglion cysts do not always cause any pain unless they are next to a nerve The cause of ganglion cysts is not known One theory suggests that trauma causes the tissue of the joint to break down forming small cysts which then join into a larger more obvious mass The most likely theory involves a flaw in the joint capsule or tendon sheath that allows the joint tissue to bulge out
Ganglion symptomsThe ganglion cyst swelling may appear over time or appear suddenly may get smaller in size and may even go away only to come back at another timeGanglions can cause some degree of pain usually following acute or repetitive trauma but many are without symptoms except for appearanceAny pain is usually nonstop aching and made worse by joint motionWhen the ganglion is connected to a tendon there may be a sense of weakness in the affected toe
Multiple images for cysts and ganglia in the forefoot
Multiple images for cysts and ganglia in the forefoot
Foot superficialis hemangiomavenous vascular malformation
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Forefoot scan plane
ULTRASOUND OF THE FOOT PROTOCOLROLE OF ULTRASOUND Ultrasound is used for the soft tissue structures of the footUltrasound is a valuable diagnostic tool in assessing the following indicationsMuscular tendinous and ligamentous damage (chronic and acute)Plantar platesBursitisSoft tissue masses such as ganglia lipomas Mortonrsquos neuromasPlantar fasciaJoint effusionsVascular pathologyHaematomasClassification of a mass eg solid cystic mixedPost surgical complications eg abscess edemaGuidance of injection aspiration or biopsySome bony pathology
A ganglion ganglion cyst or synovial cyst is a swelling filled with
fluid near a joint or tendon such as the ankle foot or fingersThe swelling looks like a smooth soft lump under the skin and can range from pea-sized to being as big as a golf ball in some casesThe swelling contains a jelly-like substance called synovial fluidGanglion cysts do not always cause any pain unless they are next to a nerve The cause of ganglion cysts is not known One theory suggests that trauma causes the tissue of the joint to break down forming small cysts which then join into a larger more obvious mass The most likely theory involves a flaw in the joint capsule or tendon sheath that allows the joint tissue to bulge out
Ganglion symptomsThe ganglion cyst swelling may appear over time or appear suddenly may get smaller in size and may even go away only to come back at another timeGanglions can cause some degree of pain usually following acute or repetitive trauma but many are without symptoms except for appearanceAny pain is usually nonstop aching and made worse by joint motionWhen the ganglion is connected to a tendon there may be a sense of weakness in the affected toe
Multiple images for cysts and ganglia in the forefoot
Multiple images for cysts and ganglia in the forefoot
Foot superficialis hemangiomavenous vascular malformation
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
ULTRASOUND OF THE FOOT PROTOCOLROLE OF ULTRASOUND Ultrasound is used for the soft tissue structures of the footUltrasound is a valuable diagnostic tool in assessing the following indicationsMuscular tendinous and ligamentous damage (chronic and acute)Plantar platesBursitisSoft tissue masses such as ganglia lipomas Mortonrsquos neuromasPlantar fasciaJoint effusionsVascular pathologyHaematomasClassification of a mass eg solid cystic mixedPost surgical complications eg abscess edemaGuidance of injection aspiration or biopsySome bony pathology
A ganglion ganglion cyst or synovial cyst is a swelling filled with
fluid near a joint or tendon such as the ankle foot or fingersThe swelling looks like a smooth soft lump under the skin and can range from pea-sized to being as big as a golf ball in some casesThe swelling contains a jelly-like substance called synovial fluidGanglion cysts do not always cause any pain unless they are next to a nerve The cause of ganglion cysts is not known One theory suggests that trauma causes the tissue of the joint to break down forming small cysts which then join into a larger more obvious mass The most likely theory involves a flaw in the joint capsule or tendon sheath that allows the joint tissue to bulge out
Ganglion symptomsThe ganglion cyst swelling may appear over time or appear suddenly may get smaller in size and may even go away only to come back at another timeGanglions can cause some degree of pain usually following acute or repetitive trauma but many are without symptoms except for appearanceAny pain is usually nonstop aching and made worse by joint motionWhen the ganglion is connected to a tendon there may be a sense of weakness in the affected toe
Multiple images for cysts and ganglia in the forefoot
Multiple images for cysts and ganglia in the forefoot
Foot superficialis hemangiomavenous vascular malformation
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
A ganglion ganglion cyst or synovial cyst is a swelling filled with
fluid near a joint or tendon such as the ankle foot or fingersThe swelling looks like a smooth soft lump under the skin and can range from pea-sized to being as big as a golf ball in some casesThe swelling contains a jelly-like substance called synovial fluidGanglion cysts do not always cause any pain unless they are next to a nerve The cause of ganglion cysts is not known One theory suggests that trauma causes the tissue of the joint to break down forming small cysts which then join into a larger more obvious mass The most likely theory involves a flaw in the joint capsule or tendon sheath that allows the joint tissue to bulge out
Ganglion symptomsThe ganglion cyst swelling may appear over time or appear suddenly may get smaller in size and may even go away only to come back at another timeGanglions can cause some degree of pain usually following acute or repetitive trauma but many are without symptoms except for appearanceAny pain is usually nonstop aching and made worse by joint motionWhen the ganglion is connected to a tendon there may be a sense of weakness in the affected toe
Multiple images for cysts and ganglia in the forefoot
Multiple images for cysts and ganglia in the forefoot
Foot superficialis hemangiomavenous vascular malformation
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Multiple images for cysts and ganglia in the forefoot
Multiple images for cysts and ganglia in the forefoot
Foot superficialis hemangiomavenous vascular malformation
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Multiple images for cysts and ganglia in the forefoot
Foot superficialis hemangiomavenous vascular malformation
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Foot superficialis hemangiomavenous vascular malformation
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Plantar fasciitis is the most common cause of heel pain presenting to the emergency department Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed Using your linear probe first identify your anatomy A measurement gt 4 mm is diagnostic of plantar fasciitis
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Plantar fasciitis
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Morton neuromas are focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot The abnormality is non-neoplastic and does not represent a true neuroma It may more correctly be known as Mortonrsquos metatarsalgia The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament Ultrasound Typically seen as a round to ovoid well-defined hypo-echoic lesion in the intermetatarsal space adjacent are proximal to the metatarsal head A small proportion can have mixed echotexture
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Multiple images for plantar bursitis
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Multiple images for plantar bursitis
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
FHL and digitorum tenosynovitis with arthritis of the joint
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Rheumatoid nodule
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Typical cobblestone appearance of cellulitis with increased vascularity
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Abscess with irregular hypoechoic area is noted in subcutaneous plane ( approximate Size - 15 x 10 x 10 mm ) It overlies the 3rd - 4th metatarsal head region On compression echoes show movement Increased perilesional vascularity is noted without vascularity in the hypoechoic area
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Abscess with irregular hypoechoic area is noted in subcutaneous region
Thank You
Thank You