MRI of the foot and ankle

Question 1

usually affected tendons of foot pathologically

Answer 1

flexor tendons, located posterior in the ankle

Question 2

tenosynovitis in achilles tendon does not occur because

Answer 2

it does not have a sheath associated with it

Question 3

achilles tendon rupture can be treated by

Answer 3

surgically or by placing the patient in a case with equinus positioning (marked plantar flexion) for several months

Question 4

flexor tendons includes

Answer 4

“Tom, Dick and Harry” posterior tibial tendon, Flexor digitorum longus tendon, Flexor hallucis longus tendon

Question 5

most medial and largest flexor tendon

Answer 5

posterior tibial tendon

Question 6

posterior tibial tendon inserts onto the (7)

Answer 6

• navicular,
• second and third cuneiforms and
• bases of the second to fourth metatarsals

Question 7

problems in the arch or plantar fascia can sometimes lead to stress on the

Answer 7

posterior tibial tendon

Question 8

treatment for PTT tendinosis and partial tears is

Answer 8

nonoperative

Question 9

rupture of posterior tibial tendon results clinically in

Answer 9

flat foot due to loss of arch support given by PTT

Question 10

ligament that runs just deep to the PTT and then goes underneath the neck of talus, which it supports in a sling-like fashion

Answer 10

spring ligament

sling-like = SS = spring

Question 11

when the spring ligament is stressed, it appears

Answer 11

scarred and thickened

Question 12

usually the only tendon near the tibiotalar joint

Answer 12

flexor hallucis longus tendon

Question 13

tendon that can be seen beneath the sustentaculum tali, which it uses as pulley to plantar flex the foot

Answer 13

flexor hallucis longus tendon

Question 14

known as the achilles tnedon of the foot in ballet dancers because of the extreme flexion positions they employ

Answer 14

flexor hallucis longus tendon

Question 15

tendons that can be seen posterior to the distal fibula, to which they are bound by a thin fibrous structure, the superior peroneal retinaculum

Answer 15

peroneus longus and peroneus brevis tendons

Question 16

serves as a pulley for the tendons to work as the principal evertor of the foot

Answer 16

fibula

Question 17

peroneus brevis tendon inserts onto

Answer 17

base of the 5th metatarsal

Question 18

peroneus longus tendon crosses under the foot and inserts onto the

Answer 18

base of the first metatarsal

LONG FIRST

Question 19

disruption of this structure, often seen in skiing accidents, can result in lateral displacement of peroneus tendons, and must be surgically corrected. it sometimes occurs with a small bony avulsion, called a flake fracture, off the fibula

Answer 19

superior peroneal retinaculum

Question 20

commonly seen in patients following an inversion ankle sprain with associated dorsiflexion

Answer 20

longitudinal split tears of peroneus brevis

Question 21

also occurs with inversion trauma of the ankle, these patients have chronic lateral ankle pain, often associated with ankle instability

Answer 21

lateral collateral ligament disruption

Question 22

V-shape or chevron defect to the tendon distal to the fibula

Answer 22

split tear of peroneus brevis

Question 23

split tear of peroneus brevis are associated with _____ 80% of the time

Answer 23

lateral ligament tears

Question 24

second most common location of an osteochondral lesion or osteochondritis dissecans

Answer 24

talar dome

Question 25

3 tumors that have a predilection for foot and ankle

Answer 25

synovial sarcomas, desmoid tumors, giant cell tumor

Question 26

MRI appearance of foot and ankle tumors

Answer 26

marked low signal in the synovial lining and in the tendons on T1 and T2 images, just as pigmented villonodular synovitis appears in a joint

Question 27

soft tissue tumors in the medial aspect of the foot and ankle can press on the posterior tibial nerve, resulting in

Answer 27

tarsal tunnel syndrome

Question 28

nerve that is compressed in tarsal tunner syndrome

Answer 28

posterior tibial nerve

Question 29

posterior tibial nerve is bounded medially by ____, a strong fibrous band that extends across the medial ankle joint for approximately 5 to 7 cm in a superior to inferior direction

Answer 29

flexor retinaculum

Question 30

most common accessory muscles encountered around the foot and ankle

Answer 30

accessory soleus and peroneus brevis muscles

Question 31

injured in over 90% of ankle sprains

Answer 31

lateral ligaments

Question 32

lateral complex ligaments are composed of two groups, the superior group contains _________ that make up part of syndesmosis

Answer 32

anterior and posterior tibiofibular ligaments

Question 33

inferior group in lateral complex ligaments contain

Answer 33

anterior and posterior talofibular ligaments and calcaneofibular ligament

Question 34

ligaments that are seen on axial images just below the tibiotalar joint and emanate from a concavity in the distal fibula called malleolar fossa

Answer 34

anterior and posterior talofibular ligaments

Question 35

most commonly torn ankle ligament is the

Answer 35

anterior talofibular ligament

Question 36

present with lateral ankle pain and tenderness and a perception of hindfoot instability

Answer 36

sinus tarsi syndrome

Question 37

cone-shped space between the talus and calcaneus that opens up laterally. it is a fat-filled space through which traverse several important ligaments that provide subtalar stability

Answer 37

sinus tarsi

Question 38

results from hypertrophy and scarring of the synovium in the lateral gutter of the ankle

Answer 38

anterolateral impingement syndrome

Question 39

space between the tibia and the fibula and is bound by the lateral ankle ligaments

Answer 39

lateral gutter

Question 40

presents with lateral ankle pain and inability to dorsiflex normally. they often have a click on dorsiflexion

Answer 40

anterolateral impingement syndrome

Question 41

common cause of a painful flat foot. occurs most commonly at the calcaneonavicular joint and the middle facet of the talocalcaneal joint

Answer 41

tarsal coalition

Question 42

definitive MR finidngs for osteomyelitis are

Answer 42

cortical disruption, a bony abscess or a sinus track