Plantar tendons of the foot: MR imaging and US.
Tendon disorders along the plantar aspect of the foot may lead to significant symptoms but are often clinically misdiagnosed. Familiarity with the normal anatomy of the plantar tendons and its appearance at magnetic resonance (MR) imaging and ultrasonography (US) is essential for recognizing plantar tendon disorders. At MR imaging, the course of the plantar tendons is optimally visualized with dedicated imaging of the midfoot and forefoot. This imaging should include short-axis images obtained perpendicular to the long axis of the metatarsal shafts, which allows true cross-sectional evaluation of the plantar tendons. Normal plantar tendons appear as low-signal-intensity structures with all MR sequences. At US, accurate evaluation of the tendons requires that the ultrasound beam be perpendicular to the tendon. The normal tendon appears as a compact linear band of echogenic tissue that contains a fine, mixed hypoechoic and hyperechoic internal fibrillar pattern. Tendon injuries can be grouped into six major categories: tendinosis, peritendinosis, tenosynovitis, entrapment, rupture, and instability (subluxation or dislocation) and can be well assessed with both MR imaging and US. The radiologist plays an important role in the diagnosis of plantar tendon disorders, and recognizing their imaging appearances at MR imaging and US is essential.
From the Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave, Room AG 278, Toronto, ON, Canada M4N 3M5 (A.D.); Department of Radiology, NYU Hospital for Joint Diseases, New York, NY (Z.S.R., J.T.B., D.B.B., G.A.C., R.S.A.); and CediMed, Medellin, Colombia (Z.R.V.).
Andrea
A
Donovan
Zehava Sadka
ZS
Rosenberg
Jenny T
JT
Bencardino
Zoraida Restrepo
ZR
Velez
David B
DB
Blonder
Gina A
GA
Ciavarra
Ronald Steven
RS
Adler
D005534:Foot Diseases / Q000175:diagnosis*; D018409:Foot Injuries / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D052256:Tendinopathy / Q000175:diagnosis*; D013708:Tendon Injuries / Q000175:diagnosis*; D014463:Ultrasonography / Q000379:methods*