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Presentation, Imaging and Treatment of Common Musculoskeletal Conditions E-Book

Presentation, Imaging and Treatment of Common Musculoskeletal Conditions E-Book

Mark D. Miller | Timothy G. Sanders

(2011)

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Book Details

Abstract

Take the mystery out of MRI interpretation and its relationship to arthroscopy with Presentation, Imaging and Treatment of Common Musculoskeletal Conditions: MR-Arthroscopy Correlation, by Drs. Mark D. Miller and Timothy G. Sanders. Abundantly illustrated with MR, arthroscopic, and anatomical images, this new title offers both orthopaedists and radiologists a correlated, systematic approach to diagnosis, helping you achieve accurate evaluations and ensuring that all clinically relevant structures are adequately assessed.

  • Improve diagnostic accuracy, surgical planning/decision making, and patient outcomes by seeing how to correlate MRI and arthroscopic findings.
  • Gain an enhanced appreciation of the sensitivity and specificity of MRI as a tool in musculoskeletal diagnosis.
  • Enhance your diagnostic skills by reviewing illustrative case studies for each major joint, examining specific MRI and arthroscopic findings and considering the range of possible diagnoses.

Take the mystery out of MRI interpretation to assess more confidently.


Table of Contents

Section Title Page Action Price
Front Cover cover
Pin page ifc_i
Video Contents ifc_ii
Presentation, Imaging and Treatment of Common Musculoskeletal Conditions Expert Consult i
Copyright Page iv
Dedication v
Contributors vii
Preface ix
Table Of Contents xi
I Introduction 1
1 The Basics of Magnetic Resonance Imaging 2
Introduction 2
Basics of MR Imaging 2
The Magnet 2
Surface Coils 3
Pulse Sequences 3
Fat-Saturation Techniques 4
Contrast Agents 5
Common MR Imaging Artifacts 5
MR Safety Issues 6
Intravenous Gadolinium: Nephrogenic Systemic Fibrosis (NFS) 8
2 Introduction to Arthroscopy 8
Introduction 8
Arthroscopic Equipment 8
Arthroscopic Team and Support 10
Arthroscopic Basics 11
Portals 13
Shoulder Arthroscopy 13
Elbow Arthroscopy 13
Wrist Arthroscopy 13
Hip Arthroscopy 21
Knee Arthroscopy 21
Ankle Arthroscopy 26
Suggested Readings 26
II Shoulder 27
3 Introduction to Magnetic Resonance Imaging of the Shoulder 28
General Facts Regarding Magnetic Resonance Imaging of the Shoulder 28
MR Imaging Technique 28
Typical Imaging Protocols 28
Anatomic Evaluation 29
Postoperative Imaging 30
4 Introduction to Arthroscopy of the Shoulder 30
Preoperative Considerations 30
Diagnostic Arthroscopy 34
References 36
Suggested Readings 36
5 Rotator Cuff Disorders 36
Anatomy and Function of the Rotator Cuff 36
Clinical Presentation 37
History 37
Physical Examination 37
Radiographs 38
Diagnosis 38
Classification of Abnormalities 38
Associated Injuries 38
MR Imaging 38
Normal Appearance 38
Direct Signs 39
Indirect Signs 41
Pearls 41
Pitfalls 42
Treatment Options 43
Operative 43
Nonoperative 43
Postoperative Rehabilitation 43
Postoperative Complications 44
Postoperative MRI Findings 44
References 46
6 Subscapularis Disorders 46
Anatomy and Function of the Subscapularis 46
Clinical Presentation 46
History 46
Physical Examination 46
Radiographs 47
Diagnosis 47
Classification of Abnormalities 47
Associated Injuries 47
Mr Imaging 47
Normal Appearance 47
Direct Signs 47
Indirect Signs 48
Pearls 48
Pitfalls 48
Treatment Options 48
Operative 48
Nonoperative 48
Postoperative Rehabilitation 48
Postoperative Complications 48
7 Pectoralis Major Injuries 48
Anatomy and Function of the Pectoralis Major 48
Clinical Presentation 49
History 49
Physical Examination 50
Radiographs 50
Diagnosis 50
Classification of Abnormalities 50
Associated Injuries 50
MR Imaging 50
Normal Appearance 50
Direct Signs 50
Indirect Signs 51
Pearls 51
Treatment Options 51
Operative 51
Nonoperative 52
Postoperative Rehabilitation 52
Postoperative Complications 53
8 Anterior Instability (Bankart, AMBRI, HAGL, GLAD) 53
Anatomy and Function 53
Clinical Presentation 53
History 53
Physical Examination 53
Radiographs 53
Diagnosis 54
Classification of Abnormalities 54
Associated Injuries 54
MR Imaging 54
Normal Appearance 54
Direct Signs 54
Indirect Signs 57
Pitfalls 57
Treatment Options 58
Operative 58
Nonoperative 58
Postoperative Rehabilitation 58
Postoperative Complications 60
Postoperative MRI Findings 60
9 Posterior Instability 60
Anatomy and Function 60
Clinical Presentation 60
History 60
Physical Examination 60
Radiographs 61
Diagnosis 61
Classification of Abnormalities 61
Associated Injuries 61
MR Imaging 61
Normal Appearance 61
Direct Signs 61
Indirect Signs 62
Pearls 62
Treatment Options 62
Operative 62
Nonoperative 63
Postoperative Rehabilitation 63
Postoperative Complications 63
Postoperative MRI Findings 63
10 Multidirectional Instability 63
Introduction 63
Clinical Examination 63
History 63
Physical Examination 64
Radiographs 64
Diagnosis 64
MR Imaging 64
Normal Appearance 64
Direct Signs 64
Indirect Signs 64
Classification of Abnormalities 65
Associated Injuries 65
Treatment Options 65
Operative 65
Nonoperative 65
Postoperative Rehabilitation 65
Postoperative Complications 65
Postoperative MRI Findings 65
11 Superior Labral Injuries 65
Anatomy and Function of the Superior Labrum 65
Clinical Presentation 65
History 65
Physical Examination 65
Radiographs 66
Diagnosis 66
Classification of Abnormalities 66
Associated Injuries 66
MR Imaging 66
Normal Appearance 66
Direct Signs 66
Indirect Signs 66
Pearls 66
Pitfalls 66
Treatment Options 66
Operative 66
Nonoperative 69
Postoperative Rehabilitation 69
Postoperative Complications 69
Postoperative MRI Findings 69
12 Internal Impingement 70
Introduction 70
Clinical Presentation 70
History 70
Physical Examination 70
Radiographs 70
Diagnosis 70
Classification of Abnormalities 70
Associated Injuries 70
MR Imaging 70
Normal Appearance 70
Direct Signs 70
Pearls 70
Pitfalls 70
Treatment Options 70
Operative 70
Nonoperative 70
Postoperative Rehabilitation 71
Postoperative Complications 71
13 Long Head Biceps Tendon Disorders 71
Anatomy and Function of the Biceps Tendon 71
Clinical Presentation 71
History 71
Physical Examination 71
Radiographs 72
Diagnosis 72
Classification of Abnormalities 72
Associated injuries 72
MR Imaging 72
Normal Appearance 72
Direct Signs 72
Indirect Signs 73
Pearls 73
Pitfalls 73
Treatment Options 74
Operative 74
Nonoperative 74
Postoperative Rehabilitation 75
Postoperative complications 75
Postoperative MRI findings 75
14 Synovial Disorders 75
Anatomy and Function of the Synovium 75
Clinical Examination 75
History 75
Physical Examination 75
Radiographs 76
Diagnosis 76
Classification of Abnormalities 76
Associated injuries 76
MR Imaging 76
Normal Appearance 76
Direct Signs 76
Pearls 76
Pitfalls 76
Treatment Options 76
Operative 76
Nonoperative 77
Postoperative Rehabilitation 77
Postoperative Complications 77
Postoperative MRI Findings 77
15 Adhesive Capsulitis (Frozen Shoulder) 78
Relevant Anatomy 78
Clinical Presentation 78
History 78
Physical Examination 78
Radiographs 78
Diagnosis 78
MR Imaging 78
Normal Appearance 78
Direct Signs 79
Indirect Signs 79
Pearls 79
Pitfalls 79
Treatment Options 79
Operative 79
Nonoperative 80
Postoperative Rehabilitation 80
Postoperative Complications 80
Suggested Reading 80
16 Nerve Entrapment Syndromes 81
Sites of Nerve Compression Around the Shoulder 81
Clinical Presentation 81
History 81
Physical Examination 82
Radiographs 83
Diagnosis 83
Classification of Abnormalities 83
Associated Injuries 83
MR Imaging 83
Normal Appearance 83
Direct Signs 84
Indirect Signs 84
Pearls 84
Treatment Options 86
Postoperative Rehabilitation 86
Postoperative Complications 86
17 Glenohumeral Articular Cartilage Lesions (Osteochondritis Dissecans) 86
Relevant Anatomy 86
Incidence 86
Etiology 86
Location 86
Clinical Presentation 86
History 86
Physical Examination 87
Risk Factors 87
Radiographs 87
Diagnosis 87
Mr Imaging 87
Normal Appearance 87
Direct Signs 87
Indirect Signs 88
Pearls 88
Pitfalls 88
Treatment Options 89
Operative (FIG 17-5) 89
Nonoperative 89
Postoperative Rehabilitation 89
Postoperative Complications 89
Postoperative MRI Findings 89
18 Acromioclavicular Disorders (Degenerative Joint Disease, Osteolysis) 89
Anatomy and Function (Fig 18-1) 89
Clinical Presentation 89
History 89
Physical Examination 89
Radiographs 89
Diagnosis 90
Classification of Abnormalities 90
Associated Injuries 90
Mr Imaging 90
Normal Appearance (FIG 18-2) 90
Direct Signs 90
Pearls 91
Pitfalls 91
Treatment Options 91
Operative 91
Nonoperative 91
Postoperative Rehabilitation 92
Postoperative Complications 92
Postoperative Mri Findings 92
19 Acromioclavicular Separations 93
Anatomy and Function 93
Clinical Presentation 93
History 93
Physical Examination 93
Radiographs 93
Diagnosis 93
Classification of Abnormalities 93
Associated Injuries 94
MRI Imaging 94
Normal Appearance 94
Direct Signs 94
Pitfalls 94
Treatment Options 94
Operative 94
Nonoperative 95
Postoperative Rehabilitation 95
Postoperative Complications 95
References 95
20 Sternoclavicular Injuries 95
Anatomy and Function of the Sternoclavicular Joint (Fig 20-1) 95
Clinical Presentation 95
History 95
Physical Examination 96
Radiographs 96
Diagnosis 96
Classification of Abnormalities 96
Associated Injuries 96
MR Imaging 96
Normal Appearance 96
Direct Signs 97
Pathology 97
Pearls 99
Pitfalls 99
Treatment Options 99
Operative 99
Nonoperative 99
Postoperative Rehabilitation 99
Postoperative Complications 99
21 Proximal Humerus Fractures 99
Anatomy and Function of the Proximal Humerus 99
Clinical Presentation 100
History 100
Physical Examination 100
Radiographs 100
Diagnosis 100
Classification of Abnormalities 100
Associated Injuries 100
MR Imaging 100
Normal Appearance 100
Direct Signs 100
Treatment Options 101
Operative (FIG 21-5) 101
Nonoperative 103
Postoperative Rehabilitation 103
Postoperative Complications 103
22 Glenoid Fractures 103
Anatomy and Function of the Glenoid 103
Clinical Presentation 103
History 103
Physical Examination 103
Radiographs (FIG 22-1) 104
Diagnosis 104
Classification of Abnormalities 104
Associated Injuries 104
MR Imaging 104
Normal Appearance 104
Direct Signs 104
Treatment Options 104
Operative 104
Nonoperative 105
Postoperative Rehabilitation 105
Postoperative Complications 105
23 Scapula Fractures 106
Anatomy and Function of the Scapula 106
Clinical Presentation 106
History 106
Physical Examination 106
Radiographs (FIG 23-1) 106
Diagnosis 106
Classification of Abnormalities 106
Associated Injuries 106
MR Imaging 106
Normal Appearance 106
Direct Signs 107
Treatment Options 107
Operative 107
Nonoperative 107
Postoperative Rehabilitation 107
Postoperative Complications 107
Scapulothoracic Dissociation 107
24 Clavicle Fractures 108
Anatomy and Function of the Clavicle 108
Clinical Presentation 108
History 108
Physical Examination 108
Radiographs 108
Diagnosis 108
Classification of Abnormalities 108
Associated Injuries 109
MR Imaging 109
Normal Appearance 109
Direct Signs 109
Pitfalls 109
Treatment Options 109
Operative 109
Nonoperative 109
Postoperative Rehabilitation 109
Postoperative Complications 109
References 109
25 Avascular Necrosis 109
Anatomy and Function 109
Clinical Presentation 109
History 109
Physical Examination 110
Radiographs 110
Diagnosis 110
Classification of Abnormalities 110
Associated Injuries 110
MR Imaging 110
Normal Appearance (FIG 25-1) 110
Direct Signs 110
Treatment Options 111
Operative 111
Nonoperative 112
Postoperative Rehabilitation 112
Postoperative Complications 112
References 112
26 Arthritides 113
Introduction 113
Clinical Presentation 113
History 113
Physical Examination 113
Radiographs 113
Diagnosis 113
Classification of Abnormalities 113
Associated Injuries 113
MR Imaging 113
Normal Appearance 113
Direct Signs 113
Pitfalls 113
Treatment Options 113
Operative 113
Nonoperative 116
Postoperative Rehabilitation 116
Postoperative Complications 116
III Elbow 117
27 Introduction to Magnetic Resonance Imaging of the Elbow 118
Introduction 118
Coils 118
Typical Elbow Mr Imaging Protocol 118
Conventional MR Imaging of the Elbow 118
Protocol Tips 118
Direct Mr Arthrography 118
Indications 118
IV Wrist and Hand 173
44 Introduction to Magnetic Resonance Imaging of the Hand and Wrist 174
General Facts Regarding Magnetic Resonance Imaging of the Hand and Wrist 174
Coils 174
Typical Hand and Wrist MR Imaging Protocols 174
Pulse Sequences 176
45 Introduction to Arthroscopy of the Wrist 176
Positioning 176
Equipment 177
Arthroscope 177
Handheld Instruments 177
Relevant Anatomy 177
Portal Placement 177
Complications 178
Diagnostic Arthroscopy 178
46 Tendon Injuries of the Wrist 181
Anatomy and Function of the Tendons of the Wrist 181
Clinical Presentation 183
History 183
Physical Examination 183
Radiographs 183
Classification of Abnormalities 184
Associated Injuries 184
MR Imaging 184
Direct Signs 184
Nontraumatic Abnormalities of the Tendons 186
Pearls and Pitfalls 186
Treatment Options 187
Nonoperative 187
Operative 187
Arthroscopic Findings 188
Surgical Care 188
Treatment Plan 188
Postoperative plan 189
Postoperative Complications 189
Immediate 189
Delayed 189
Postoperative MR Imaging of the Tendons of the Wrist 189
47 Tendon Injuries and Tendinopathies of the Hand 189
Anatomy and Function of the Tendons of the Hand and Fingers 189
Clinical Presentation 190
History 190
Physical Examination 190
Radiographs 190
Classification of Abnormalities 190
Flexor Tendon Injury in the Hand 190
Extensor Tendon Injuries in the Hand 191
Associated Injuries 191
MR Imaging 191
Normal Appearance 191
Direct Signs 191
Indirect Signs 191
Nontraumatic Abnormalities of the Tendons 191
Pearls and Pitfalls 191
Treatment Options 192
Nonoperative 192
Operative 192
Flexor Tendon Repairs 194
Extensor Tendon Repairs 194
Arthroscopic Findings 194
Surgical Care 194
Treatment Plan 194
Postoperative Plan 194
Postoperative Complications 194
Immediate 194
Delayed 194
Postoperative MR Imaging 194
48 Trigger Finger and Pulley Injuries 195
Anatomy and Function of Trigger Finger and Pulley Injuries 195
Clinical Presentation 195
History 195
Physical Examination 195
Radiographs 196
Classification of Abnormalities 196
Associated Injuries 196
MR Imaging 196
Normal Appearance of the Pulley Mechanism 197
Direct Signs 197
Indirect Signs 198
Pearls 198
Treatment Options 199
Nonoperative 199
Operative 199
Arthroscopic Findings 199
Surgical Care 199
Treatment Plan 199
Postoperative Plan 199
Postoperative Complications 199
Immediate 199
Delayed 199
Postoperative MR Imaging 199
49 Ligamentous Injuries of the Wrist (Carpal Instability) 200
Anatomy and Function of the Ligaments of the Wrist 200
Clinical Presentation 200
History 200
Physical Examination 200
Radiographs 200
Classification of Abnormalities 201
Associated Injuries 203
MR Imaging 203
Normal Appearance 203
Direct Signs 203
Indirect Signs 205
Pearls and Pitfalls 205
Treatment Options 206
Nonoperative 206
Operative 206
Arthroscopic Findings 206
Surgical Care 207
Treatment Plan 207
Postoperative Complications 208
Immediate 208
Delayed 208
Postoperative Imaging 208
50 Ligamentous Injuries of the Hand 208
Anatomy and Function of the Ligaments of the Hand 208
Clinical Presentation (Ulnar Collateral Ligament [UCL] Tear of the Thumb MCP Joint) 208
History 208
Physical Examination 208
Radiographs 209
Classification of Abnormalities 209
Associated Injuries 209
MR Imaging 210
Normal Appearance 210
Direct Signs 210
Indirect Signs 211
Pearls and Pitfalls 211
Treatment Options 211
Nonoperative 211
Operative 211
Arthroscopic Findings 212
Surgical Care 212
Treatment Plan 212
Postoperative Plan 212
Postoperative Complications 212
Immediate 212
Delayed 212
Postoperative Imaging 212
51 Triangular Fibrocartilage Complex Injuries 212
Anatomy and Function of the Triangular Fibrocartilage Complex 212
Clinical Presentation 213
History 213
Physical Examination 213
Radiographs 213
Classification of Abnormalities 213
Associated Injuries 213
MR Imaging 213
Normal Appearance 213
Direct Signs 214
Indirect Signs 216
Pearls and Pitfalls 216
Treatment Options 216
Operative 216
Nonoperative 216
Arthroscopic Findings 216
Surgical Care 218
Treatment Plan 218
Postoperative Plan 218
Postoperative Complications 219
Immediate 219
Delayed 219
Postoperative MRI Findings 219
Normal Postoperative MR Imaging Appearance 219
52 Abutment Disorders 219
Anatomy and Function of Ulnar-Sided Abutment Syndromes 219
Clinical Presentation 220
History 220
Physical Examination 220
Radiographs 220
Classification of Abnormalities 220
Associated Injuries 220
MR Imaging 220
Ulnar-Lunate Abutment 220
Direct Signs 220
V Hip 291
62 Introduction to Magnetic Resonance Imaging of the Hip 292
General Facts Regarding Magnetic Resonance Imaging of the Hip 292
Coils 292
Pulse Sequences—Characteristics and General Uses 292
Other Techniques 292
General MR Imaging Tips 293
Typical Hip MR Imaging Protocol 294
MR Imaging of the Hip 294
Direct MR Arthrography 294
Indirect MR Arthrography 296
Advanced Imaging (Fig 62-8) 296
Mechanical Imaging 296
Suggested Readings 296
63 Introduction to Arthroscopy of the Hip 296
Introduction to Arthroscopy of the Hip 296
Hip Imaging 296
MR Imaging of the Hip Technique 297
Typical Hip MR Imaging Protocol 297
Unilateral Hip Protocol: Bony Architecture 297
Unilateral Hip Protocol: Labral and Intraarticular Evaluation 297
Alternative Hip Protocol 297
Patient Selection 297
Hip Arthroscopy Indications 297
Central Compartment 297
Peripheral Compartment 297
Peritrochanteric (Lateral) Compartment 297
Iliopsoas Bursoscopy 298
Hip Arthroscopy Contraindications 298
Relevant Anatomy 298
Acetabulum 298
Femoral Head Neck Junction 298
Ligaments 298
Muscles 298
Neurovascular Anatomy 298
Surgical Positioning 298
Additional Pearls 299
Equipment 299
Portal Placement 299
Diagnostic Arthroscopy 300
Central Compartment 300
Peripheral Compartment 301
Peritrochanteric Compartment 302
Iliopsoas Bursoscopy 302
Postoperative Care 302
VI Knee 389
76 Introduction to Magnetic Resonance Imaging of the Knee 390
Introduction 390
Coils 390
Typical Knee MR Imaging Protocol 390
Pulse Sequences 392
77 Introduction to Arthroscopy of the Knee 392
Introduction 392
Preoperative Considerations 392
Examination Under Anesthesia 393
Positioning (FIG 77-1) 393
Equipment (FIG 77-2) 393
Relevant Anatomy (FIG 77-3) 393
Portal Placement (FIG 77-4) 394
Diagnostic Arthroscopy (FIG 77-5) 395
Complications 399
78 Meniscal Disorders 404
Anatomy and Function of the Menisci 404
Clinical Presentation 404
History 404
Physical Examination 404
Radiographs 404
Classification of Abnormalities 404
Associated Injuries 404
MR Imaging 404
Direct Signs 406
Indirect Signs 406
Nontraumatic Abnormalities 407
Pearls 408
Pitfalls 409
Treatment Options 411
Operative 411
Nonoperative 411
Surgical Care 412
Treatment plan 412
Postoperative Plan 412
Postoperative Complications 412
Postoperative MR Imaging Findings 412
79 Anterior Cruciate Ligament 419
Anatomy and Function of the Anterior Cruciate Ligament 419
Clinical Presentation 419
History 419
Physical Examination 420
Radiographs 420
Classification of Abnormalities 421
Associated Injuries 421
MR Imaging 421
Direct Signs 421
Indirect Signs 423
Nontraumatic Abnormalities 424
Pearls 425
Pitfalls 425
Treatment Options 426
Operative 426
Nonoperative 427
Arthroscopic Findings 427
Surgical Care 427
Treatment Plan 427
Postoperative Plan 427
Postoperative Complications 427
Immediate 427
Delayed 427
Postoperative MRI Findings 428
Normal Postoperative MR Imaging Appearance 428
MR Imaging of Postoperative Complications 428
80 Posterior Cruciate Ligament 430
Anatomy and Function of the Posterior Cruciate Ligament 430
Clinical Presentation 430
History 430
Physical Examination 432
Radiographs 432
Classification of Abnormalities 432
Associated Injuries 432
MR Imaging 432
Direct Signs 432
Indirect Signs 433
Nontraumatic Abnormalities 433
Pearls 434
Pitfalls 434
Treatment Options 434
Operative 434
Nonoperative 434
Arthroscopic Findings 434
Surgical Care 434
Treatment Plan 434
Postoperative Plan 436
Postoperative Complications 436
Immediate 436
Delayed 436
Postoperative MR Imaging Findings 436
Normal Postoperative MR Imaging Appearance 436
MR Imaging of Postoperative Complications 436
81 Medial Collateral Ligament/Posteromedial Complex 437
Anatomy and Function of the Medial Collateral Ligament Complex 437
Clinical Presentation 437
History 437
Physical Examination 437
Radiographs 437
Classification of Medial Collateral Ligament Injury 437
Associated Injuries 438
MR Imaging 438
Direct Signs 440
Indirect Signs 441
Pearls 441
Pitfalls 441
Treatment Options 441
Operative 441
Nonoperative 441
Arthroscopic Findings 441
Surgical Care 441
Treatment Plan 441
Postoperative Plan 442
Postoperative Complications 442
Immediate 442
Delayed 442
Postoperative MR Imaging 444
82 Lateral Collateral Ligament Complex and Posterolateral Corner Structures 444
Anatomy and Function of the Lateral Collateral Ligament Complex and Posterolateral Corner Structures 444
Clinical Presentation 444
History 444
Physical Examination 444
Radiographs 446
Classification of Abnormalities 446
Associated Injuries 447
MR Imaging 447
Iliotibial Band Abnormalities 447
VII Leg 527
94 Introduction to Magnetic Resonance Imaging of the Foot and Ankle 528
General Facts Regarding Magnetic Resonance Imaging of the Foot and Ankle 528
Coils 528
Typical Ankle MR Imaging Protocols 528
Typical Foot MR Imaging Protocols 528
95 Introduction to Arthroscopy of the Ankle 530
Introduction 530
Relevant Anatomy 530
Preoperative Considerations 533
Perioperative Considerations 534
Portal Placement 535
Diagnostic Arthroscopy 536
Complications 538
Suggested Readings 538
96 Achilles Tendon Disorders 538
Anatomy and Function 538
Achilles Tendinopathies 539
Clinical Presentation 539
History 539
Physical Examination 539
Radiographs 539
Classification 540
MR Imaging 540
Normal Appearance 540
Direct MR Imaging Signs 540
Indirect MR Imaging Signs 541
Pearls 541
Pitfalls 542
Treatment Options 542
Operative 542
Nonoperative 542
Arthroscopic Findings 542
Surgical Care 542
Treatment Plan 542
Postoperative Plan 543
Postoperative Complications 543
Immediate 543
Delayed 543
Postoperative MR Imaging 543
Normal Postoperative MR Imaging Appearance 543
MR Imaging of Postoperative Complications 544
Achilles Tendon Rupture 544
Clinical Presentation 544
History 544
Physical Examination 544
Radiographs 545
Classification 545
MR Imaging 545
Direct Signs 545
Indirect Signs 545
Pearls 545
Pitfalls 545
Treatment Options 545
Surgical Care 546
Treatment Plan 546
Postoperative Plan 546
Postoperative Complications 546
Immediate 546
Delayed 546
Postoperative MR Imaging 546
Normal Postoperative MR Imaging Appearance 546
MR Imaging of Postoperative Complications 547
Suggesting Readings 547
97 Flexor Tendon Disorders 547
Anatomy and Function 547
Adult Acquired Flatfoot 548
Clinical Presentation 548
History 548
Physical Examination 548
Radiographs 550
Classification of AAFD 550
Associated Injuries 551
MR Imaging 551
Normal Appearance 551
Direct Signs 551
Indirect Signs 552
Pitfalls 552
Treatment Options 552
Operative 552
Nonoperative 552
Surgical Care 554
Treatment Plan 554
Postoperative Plan 556
Postoperative Complications 556
Immediate 556
Delayed 557
Postoperative MR Imaging 557
Normal Postoperative MRI Appearance 557
Flexor Hallucis Longus Tenosynovitis 557
Clinical Presentation 557
History 557
Physical Examination 557
Radiographs 557
Associated Injuries 558
MR Imaging 558
Normal Appearance 558
Direct Signs 558
Indirect Signs 558
Pearls 558
Pitfalls 558
Treatment Options 558
Operative 559
Nonoperative 559
Surgical Care 559
Treatment Plan 559
Postoperative Plan 559
Postoperative Complications 559
Postoperative MR Imaging 559
Normal Postoperative MR Imaging Appearance 559
MR Imaging of Postoperative Complications 559
Suggested Readings 559
98 Peroneal Tendon Disorders 560
Anatomy and function 560
Peroneal Tendinopathy 561
Clinical Presentation 561
History 561
Physical Examination 561
Radiographs 562
Classification of Abnormalities 562
Associated Injuries 562
MR Imaging 562
Normal Appearance 562
Direct Signs 562
Indirect Signs 563
Nontraumatic Abnormalities 563
Pearls 563
Pitfalls 563
Treatment Options 565
Operative 565
Nonoperative 565
Arthroscopic Findings 565
Surgical Care 565
Treatment Plan 565
Postoperative Plan 565
Postoperative Complications 565
Immediate 565
Delayed 565
Postoperative MRI Findings 566
Normal Postoperative MRI Appearance 566
MR Imaging of Postoperative Complications 566
Peroneal Tendon Subluxation 567
Clinical Presentation 567
History 567
Physical Examination 567
Radiographs 567
Classification of Abnormalities 568
Associated Injuries 568
MR Imaging 568
Normal Appearance 568
Direct Signs 568
Indirect Signs 568
Pearls 568
Pitfalls 568
Treatment Options 568
Operative 568
Nonoperative 568
Surgical Care 569
Treatment Plan 569
Postoperative Plan 569
Postoperative Complications 570
Postoperative MR Imaging Findings 570
Normal Postoperative MR Imaging Appearance 570
MR Imaging of Postoperative Complications 570
Suggested Readings 570
99 Extensor Tendon Disorders 571
Anatomy and Function of the Foot and Ankle Extensor Tendons 571
Clinical Presentation of Tibialis Anterior Tendon Rupture 571
History 571
Physical Examination 572
Radiographs 573
Classification of Abnormalities 573
Associated Injuries 573
MR Imaging 573
Normal Appearance 573
Direct Signs 573
Indirect Signs 573
Pearls 574
Pitfalls 574
Treatment Options 574
Operative 574
Nonoperative 574
Arthroscopic Findings 575
Surgical Care 575
Treatment Plan 575
Postoperative Plan 576
Postoperative Complications 576
Immediate 576
Delayed 576
Postoperative MR Imaging Findings 576
Normal Postoperative MRI Appearance 576
MR Imaging of Postoperative Complications 576
Suggested Readings 576
100 Compartment Syndrome 576
Anatomy and Function of the Compartments of the Leg 576
Clinical Presentation 576
History 576
Physical Examination 577
Radiographs 577
Classification of Abnormalities 577
Associated Injuries 577
MR Imaging 577
Direct Signs 577
Pearls 578
Pitfalls 578
Treatment Options 578
Operative 578
Nonoperative 578
Endoscopic Findings 578
Surgical Care 578
Treatment Plan 578
Postoperative Plan 579
Postoperative Complications 579
Immediate 579
Delayed 579
Postoperative MRI Findings 579
Normal Postoperative MRI Appearance 579
MR Imaging of Postoperative Complications 579
Suggested Readings 579
101 Calf Injuries 579
Anatomy and Function of the Calf 580
Clinical Presentation 580
History 580
Physical Examination 580
Radiographs 580
Classification of Abnormalities 580
Associated Injuries 580
MR Imaging 580
Normal Appearance 580
Direct Signs 580
Indirect Signs 580
Pitfalls 580
Treatment Options 580
Operative 580
Nonoperative 581
Arthroscopic Findings 581
Surgical Care 581
Treatment Plan 581
Suggested Readings 581
102 Chronic Ankle Instability 582
Anatomy and Function of the Medial and Lateral Ankle Ligaments 582
Clinical Presentation 582
History 582
Physical Examination 582
Radiographs 583
Classification of Abnormalities 584
Associated Injuries 584
MR Imaging 584
Normal Appearance 584
Direct Signs 584
Indirect Signs 586
Pearls 586
Pitfalls 586
Treatment Options 586
Operative 586
Nonoperative 587
Arthroscopic Findings 587
Surgical Care 588
Treatment Plan 588
Postoperative Plan 590
Postoperative Complications 590
Immediate 590
Delayed 590
Postoperative MR Imaging Findings 591
Suggested Readings 591
103 Acute Ankle Ligament Injuries 591
Anatomy and Function 591
Clinical Presentation 592
History 592
Physical Examination 592
Radiographs 593
Classification of Abnormalities 594
Associated Injuries 595
MR Imaging 595
Normal Appearance 595
Direct Signs 595
Indirect Signs 595
Pearls 595
Pitfalls 595
Treatment Options 596
Operative 596
Nonoperative 596
Arthroscopic Findings 597
Surgical Care 597
Treatment Plan 597
Postoperative Plan 598
Postoperative Complications 599
Immediate 599
Delayed 599
Postoperative MRI Findings 599
Normal Postoperative MRI Appearance 599
Suggested Readings 599
104 Ligamentous Injuries of the Foot 600
Anatomy and Function of the Foot 600
Clinical Presentation 600
History 600
Physical Examination 600
Radiographs 601
Classification of Abnormalities 602
Associated Injuries 602
MR Imaging 602
Normal Appearance 602
Direct Signs 603
Indirect Signs 603
Pearls 603
Pitfalls 603
Treatment Options 604
Operative 604
Nonoperative 604
Arthroscopic Findings 604
Surgical Care 604
Treatment Plan 604
Postoperative Plan 605
Postoperative Complications 606
Immediate 606
Delayed 606
Postoperative MRI Findings 606
Postoperative Appearance 606
Suggested Readings 607
105 Osteochondral Lesions 607
Anatomy and Function 607
Osteochondral Lesion of the Talus 607
Clinical Presentation 607
History 607
Physical Examination 607
Radiographs 607
Classification of Abnormalities 608
Associated Injuries 609
MR Imaging 609
Normal Appearance 609
Direct Signs 609
Indirect Signs 609
Nontraumatic Abnormalities 609
Pearls 609
Pitfalls 610
Treatment Options 610
Operative 610
Nonoperative 610
Arthroscopic Findings 610
Surgical Care 611
Treatment Plan 611
Postoperative Plan 612
Postoperative Complications 613
Immediate 613
Delayed 613
Postoperative MRI Findings 613
Normal Postoperative MRI Appearance 613
Freiberg’s Disease 613
Clinical Presentation 613
History 613
Physical Examination 614
Radiographs 614
Classification of Abnormalities 615
Associated Injuries 615
MR Imaging 615
Normal Appearance 615
Direct Signs 615
Indirect Signs 615
Pearls 615
Treatment Options 615
Operative 615
Nonoperative 615
Arthroscopic Findings 615
Surgical Care 615
Treatment Plan 615
Postoperative Plan 616
Postoperative Complications 616
Immediate 616
Delayed 616
Postoperative MRI Findings 617
Normal Postoperative MRI Appearance 617
Suggested Readings 617
106 Impingement Syndromes 617
Anatomy and Function of the Ankle 617
Posterior Ankle Impingement Syndrome 618
Clinical Presentation 618
History 618
Physical Examination 618
Radiographs 618
Classification of Abnormalities 618
Associated Injuries 618
MR Imaging 618
Normal Appearance 618
Direct Signs 619
Indirect Signs 619
Pearls 620
Pitfalls 620
Treatment Options 620
Operative 620
Nonoperative 620
Arthroscopic Findings 620
Surgical Care 620
Treatment Plan 620
Postoperative Plan 620
Postoperative Complications 620
Immediate 620
Delayed 621
Postoperative MRI Findings 621
Normal Postoperative MRI Appearance 621
MR Imaging of Postoperative Complications 621
Anterior Ankle Impingement Syndrome 621
Clinical Presentation 621
History 621
Physical Examination 621
Radiographs 622
Classification of Abnormalities 622
Associated Injuries 622
MR Imaging 622
Normal Appearance 622
Direct Signs 622
Indirect Signs 623
Pearls 623
Pitfalls 623
Treatment Options 623
Operative 623
Nonoperative 623
Arthroscopic Findings 623
Surgical Care 623
Treatment Plan 623
Postoperative Plan 625
Postoperative Complications 625
Immediate 625
Delayed 625
Postoperative MRI Findings 625
Normal Postoperative MRI Appearance 625
MR Imaging of Postoperative Complications 625
Suggested Readings 625
107 Nerve Entrapment Syndromes 626
Anatomy and Function 626
Morton’s Neuroma 627
Clinical Presentation 627
History 627
Physical Examination 627
Radiographs 627
Classification of Abnormalities 627
Associated Injuries 627
MR Imaging 627
Normal Appearance 627
Direct Signs 627
Indirect Signs 627
Pearls 628
Pitfalls 628
Treatment Options 628
Operative 628
Nonoperative 628
Arthroscopic Findings 628
Surgical Care 628
Treatment plan 628
Postoperative Plan 629
Postoperative Complications 629
Immediate 629
Delayed 629
Postoperative MRI Findings 629
MRI Imaging of Postoperative Complications 629
Tarsal Tunnel Syndrome 629
Clinical Presentation 629
History 629
Physical Examination 630
Radiographs 630
Classification of Abnormalities 630
Associated Injuries 630
MR Imaging 630
Normal Appearance 630
Direct Signs 630
Indirect Signs 630
Treatment Options 630
Operative 630
Nonoperative 631
Arthroscopic Findings 631
Surgical Care 631
Treatment Plan 631
Postoperative Plan 632
Postoperative Complications 632
Immediate 632
Delayed 632
Postoperative MRI Findings 632
MR Imaging of Postoperative Complications 632
Lateral Plantar Nerve Compression 632
Clinical Presentation 632
History 632
Physical Examination 633
Radiographs 633
Classification of Abnormalities 633
Associated Injuries 633
MR Imaging 633
Direct Signs 633
Indirect Signs 633
Treatment Options 633
Operative 633
Nonoperative 633
Arthroscopic Findings 633
Surgical Care 633
Treatment Plan 633
Postoperative Plan 634
Postoperative Complications 634
Immediate 634
Delayed 634
Superficial Peroneal Nerve Compression 634
Clinical Presentation 634
History 634
Physical Examination 634
Radiographs 635
Classification of Abnormalities 635
Associated Injuries 635
MR Imaging 635
Treatment Options 635
Operative 635
Nonoperative 635
Arthroscopic Findings 635
Surgical Care 635
Treatment plan 635
Postoperative Plan 635
Postoperative Complications 635
Immediate 635
Delayed 635
Suggested Readings 635
108 The Plantar Fascia 636
Anatomy and Function of the Plantar Fascia 636
Clinical Presentation 636
History 636
Physical Examination 637
Radiographs 637
Classification of Abnormalities 637
Associated Injuries 637
Mr Imaging 637
Normal Appearance 637
Direct Signs 638
Indirect Signs 638
Treatment Options 638
Operative 638
Nonoperative 639
Arthroscopic Findings 640
Surgical Care 640
Treatment Plan 640
Postoperative Plan 642
Postoperative Complications 642
Immediate 642
Delayed 642
Postoperative MRI Findings 642
Normal Postoperative MRI Appearance 642
Suggested Readings 642
109 Bunions/Bunionettes 643
Anatomy and Function of the Metatarsophalangeal Joints 643
Bunions 644
Clinical Presentation 644
History 644
Physical Examination 644
Radiographs 645
Classification of Abnormalities 646
Associated Injuries 646
MR Imaging 646
Normal Appearance 646
Pearls 646
Pitfalls 647
Treatment Options 647
Operative 647
Nonoperative 648
Arthroscopic Findings 648
Surgical Care 648
Treatment Plan 648
Postoperative Plan 651
Postoperative Complications 652
Immediate 652
Delayed 652
Bunionettes 653
Clinical Presentation 653
History 653
Physical Examination 653
Radiographs 653
Classification of Abnormalities 653
Associated Injuries 653
Mr Imaging 653
Normal Appearance 653
Treatment Options 653
Operative 653
Nonoperative 653
Arthroscopic Findings 654
Surgical Care 654
Treatment Plan 654
Postoperative Plan 654
Postoperative Complications 654
Immediate 654
Delayed 655
Suggested Readings 655
110 Claw and Hammer Toes 655
Anatomy and Function of the Toes 655
Clinical Presentation 656
History 656
Physical Examination 656
Radiographs 657
Classification Of Abnormalities 657
Associated Injuries 658
Mr Imaging 658
Treatment Options 658
Operative 658
Nonoperative 658
Arthroscopic Findings 658
Surgical Care 658
Treatment Plan 658
Postoperative Plan 662
Postoperative Complications 662
Immediate 662
Delayed 662
Postoperative MRI Findings 662
Suggested Readings 662
111 Tarsal Coalition 662
Anatomy and Function of the Hindfoot 662
Clinical Presentation 663
History 663
Physical Examination 663
Radiographs 663
Classification of Abnormalities 664
Associated Injuries 664
MR Imaging 664
Normal Appearance 664
Direct Signs 665
Indirect Signs 665
Pitfalls 665
Treatment Options 665
Operative 665
Nonoperative 666
Arthroscopic Findings 667
Surgical Care 667
Postoperative Plan 668
Postoperative Complications 668
Immediate 668
Delayed 668
Postoperative MR Imaging 669
MR Imaging of Postoperative Complications 669
Suggested Readings 669
112 Disorders of the Hallucal Sesamoids 669
Anatomy and Function of the Sesamoids 669
Clinical Presentation 670
History 670
Physical Examination 670
Radiographs 670
Classification of Abnormalities 670
Associated Injuries 671
MR Imaging 671
Normal Appearance 671
Direct Signs 671
Indirect Signs 671
Nontraumatic Abnormalities 671
Pearls 671
Treatment Options 672
Operative 672
Nonoperative 672
Arthroscopic Findings 673
Surgical Care 673
Treatment Plan 673
Postoperative Complications 674
Immediate 674
Delayed 674
Postoperative MRI Findings 674
Suggested Readings 674
113 Stress Fractures of the Foot and Ankle 674
Anatomy and Function 674
Clinical Presentation 675
History 675
Physical Examination 676
Radiographs 676
Classification of Abnormalities 676
Associated Injuries 676
MR Imaging 676
Normal Appearance 676
Direct Signs 676
Indirect Signs 677
Nontraumatic Abnormalities 677
Pitfalls 678
Treatment Options 678
Operative 678
Nonoperative 678
Arthroscopic Findings 678
Surgical Care 679
Treatment Plan 679
Postoperative Plan 680
Postoperative Complications 680
Immediate 680
Delayed 680
Postoperative MRI Findings 681
Suggested Readings 681
114 Ankle Fractures 681
Anatomy and Function of the Ankle 681
Clinical Presentation 682
History 682
Physical Examination 682
Radiographs 682
Classification of Abnormalities 683
Associated Injuries 684
MR Imaging 685
Normal Appearance 685
Pearls 685
Treatment Options 685
Operative 685
Nonoperative 686
Arthroscopic Findings 687
Surgical Care 687
Treatment Plan 687
Postoperative Plan 689
Postoperative Complications 690
Immediate 690
Delayed 690
Suggested Readings 690
115 Tarsal Fractures 690
Anatomy and Function of the Tarsal Bones 691
Calcaneus Fractures 692
Clinical Presentation 692
History 692
Physical Examination 693
Radiographs 693
Classification of Abnormalities 694
Associated Injuries 694
Mr Imaging 695
Treatment Options 695
Operative 695
Nonoperative 695
Arthroscopic Findings 696
Surgical Care 696
Treatment Plan 696
Postoperative Plan 698
Postoperative Complications 698
Immediate 698
Delayed 698
Postoperative MRI Findings 698
Talus Fractures/Dislocations 698
Clinical Presentation 698
History 698
Physical Examination 699
Radiographs 699
Classification of Abnormalities 700
Associated Injuries 701
Treatment Options 701
Operative 701
Nonoperative 702
Arthroscopic Findings 702
Surgical Care 702
Treatment Plan 702
Postoperative Plan 704
Postoperative Complications 704
Immediate 704
Delayed 705
Postoperative Mri Findings 705
MR Imaging of Postoperative Complications 705
Navicular Fractures 705
Clinical Presentation 705
History 705
Physical Examination 705
Classification of Abnormalities 706
Associated Injuries 706
Treatment Options 706
Operative 706
Nonoperative 706
Arthroscopic Findings 706
Surgical Care 707
Treatment Plan 707
Postoperative Plan 707
Postoperative Complications 707
Immediate 707
Delayed 707
Cuboid Fractures 707
Clinical Presentation 707
History 707
Physical Examination 708
Classification Of Abnormalities 709
Associated Injuries 709
Treatment Options 709
Operative 709
Nonoperative 709
Arthroscopic Findings 709
Surgical Care 709
Treatment Plan 709
Postoperative Plan 709
Postoperative Complications 709
Immediate 709
Delayed 709
Suggested Readings 709
116 Foot Fractures 710
Anatomy and Function of the Forefoot 710
Clinical Presentation 711
History 711
Physical Examination 711
Radiographs 711
Classification of Abnormalities 711
Associated Injuries 712
MR Imaging 712
Treatment Options 712
Operative 712
Nonoperative 712
Arthroscopic Findings 714
Surgical Care 714
Treatment Plan 714
Postoperative Plan 717
Postoperative Complications 718
Immediate 718
Delayed 718
Suggested Readings 718
117 The Diabetic Foot 718
Anatomy and Function 718
Clinical Presentation 719
History 719
Physical Examination 719
Radiographs 720
Classification of Abnormalities 720
Associated Injuries 722
MR Imaging 722
Normal Appearance 722
Direct Signs 722
Indirect Signs 724
Pearls 724
Pitfalls 724
Treatment Options 724
Operative 724
Nonoperative 725
Arthroscopic Findings 726
Surgical Care 726
Treatment Plan 726
Postoperative Plan 727
Postoperative Complications 727
Immediate 727
Delayed 727
Postoperative MRI Findings 727
Normal Postoperative MRI Appearance 727
Suggested Readings 727
118 Arthritides of the Foot and Ankle 728
Anatomy and Function of the Foot and Ankle 728
Tibiotalar Arthritis 729
Clinical Presentation 729
History 729
Physical Examination 729
Radiographs 729
Classification of Abnormalities 731
Associated Injuries 731
MR Imaging 731
Normal Appearance 731
Pearls 731
Pitfalls 731
Treatment Options 732
Operative 732
Nonoperative 733
Arthroscopic Findings 733
Surgical Care 733
Treatment Plan 733
Postoperative Plan 735
Postoperative Complications 735
Immediate 735
Delayed 735
Hindfoot Arthritis 737
Clinical Presentation 737
History 737
Physical Examination 737
Radiographs 738
Classification of Abnormalities 738
Associated Injuries 738
Treatment Options 739
Operative 739
Nonoperative 740
Arthroscopic Findings 740
Surgical Care 740
Treatment Plan 740
Postoperative Plan 742
Postoperative Complications 742
Immediate 742
Delayed 742
Midfoot Arthritis 742
Clinical Presentation 742
History 742
Physical Examination 742
Radiographs 742
Classification of Abnormalities 742
Associated Injuries 742
Treatment Options 743
Operative 743
Nonoperative 743
Arthroscopic Findings 743
Surgical Care 743
Treatment Plan 743
Postoperative Plan 744
Postoperative Complications 745
Immediate 745
Delayed 745
Forefoot/First MTP Arthritis 745
Clinical Presentation 745
History 745
Physical Examination 745
Radiographs 747
Classification of Abnormalities 747
Associated Injuries 747
Treatment Options 748
Operative 748
Nonoperative 749
Arthroscopic Findings 749
Surgical Care 749
Treatment Plan 749
Postoperative Plan 752
Postoperative Complications 752
Immediate 752
Delayed 752
Suggested Readings 752
Index 753
A 753
B 753
C 753
D 757
E 759
F 759
G 760
H 760
I 760
J 764
K 764
L 764
M 764
N 766
O 766
P 766
R 770
S 770
T 770
U 772
V 772
W 772