Papineni Vijay Ram Kumar, Mariathas Matthew, Sidhu Sandeep Singh, Chari Basavaraj
Consultant Musculoskeletal Radiologist, Sheikh Shakhbout Medical City (Mayo Clinic), Abu Dhabi, United Arab Emirates.
Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
J Clin Orthop Trauma. 2024 Jan 5;48:102329. doi: 10.1016/j.jcot.2023.102329. eCollection 2024 Jan.
Chronic foot and ankle pain, in contrast to acute traumatic injuries, presents a diagnostic challenge due to its diverse underlying causes. Accurate diagnosis often necessitates the utilization of various imaging modalities, emphasizing the importance of selecting the most appropriate one. The intricate structure of the foot, composed of multiple bones and supported by soft tissues like ligaments and plantar fascia, gives rise to a spectrum of mechanical disorders, including stress fractures, plantar fasciitis, Morton's neuroma, and more. In addition to mechanical issues, non-acute abnormalities encompass inflammatory diseases affecting tendons and joints, benign tumors, tumor-like lesions, vascular abnormalities, and others. This article reviews the indispensable role of imaging in the assessment of these conditions, with a focus on plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine studies, tailored to the specific clinical presentation. By providing insights into the selection and interpretation of imaging modalities, this article aims to assist clinicians in achieving accurate diagnoses and optimizing patient care for nonacute foot and ankle pathologies.
与急性创伤性损伤不同,慢性足踝疼痛因其潜在病因多样而带来诊断挑战。准确诊断通常需要使用各种成像方式,这凸显了选择最合适成像方式的重要性。足部结构复杂,由多块骨头组成,并由韧带和足底筋膜等软组织支撑,由此产生了一系列机械性疾病,包括应力性骨折、足底筋膜炎、莫顿神经瘤等。除了机械性问题,非急性异常还包括影响肌腱和关节的炎症性疾病、良性肿瘤、肿瘤样病变、血管异常等。本文综述了成像在评估这些病症中的不可或缺的作用,重点介绍了根据具体临床表现量身定制的X线平片、计算机断层扫描(CT)、磁共振成像(MRI)和核医学检查。通过深入探讨成像方式的选择和解读,本文旨在帮助临床医生对非急性足踝病变进行准确诊断并优化患者护理。