Radiology & Imaging, Hospital for Special Surgery, 535 E 70th Street, New York, NY, 10021.
Zucker School of Medicine, Northwell, 2000 Marcus Ave., Suite 300, New Hyde Park, 11042-1069, NY, USA.
J Perinat Med. 2024 Aug 27;52(7):674-687. doi: 10.1515/jpm-2024-0276. Print 2024 Sep 25.
Foot and ankle disorders are common during pregnancy, driven by significant physiological changes including weight distribution, hormonal fluctuations, and fluid balance. These changes often result in conditions such as varicose veins, thrombophlebitis, deep vein thrombosis (DVT), edema, overpronation, ankle sprains, metatarsalgia, stress fractures, ligament tears, synovitis, tendon tears, tenosynovitis, paratenonitis, plantar fasciitis, and Morton's neuroma. This paper emphasizes the diagnostic utility of ultrasound for these conditions, given its safety, non-invasiveness, and real-time imaging capabilities without ionizing radiation. Ultrasound is particularly effective for diagnosing venous disorders like varicose veins and thrombophlebitis, leveraging Doppler ultrasound to assess vein structure and function. It is also instrumental in identifying DVT, detecting vein dilation, reflux, and thrombosis. For conditions such as edema, ultrasound helps differentiate physiological from pathological causes, ensuring accurate diagnosis and management. In cases of musculoskeletal issues like overpronation, ankle sprains, ligament tears, and tendon pathologies, ultrasound provides detailed images of soft tissues, allowing for precise diagnosis and effective treatment planning. It is equally useful for detecting metatarsalgia, plantar fasciitis, and Morton's neuroma, offering insights into soft tissue abnormalities and guiding therapeutic interventions. Ultrasound's role extends to diagnosing foreign bodies in the foot and ankle, where it demonstrates high sensitivity and specificity. The accessibility and cost-effectiveness of ultrasound make it an invaluable tool in various healthcare settings, ensuring timely and accurate diagnosis and management of foot and ankle disorders during pregnancy, ultimately enhancing patient outcomes and quality of life.
足部和踝关节疾病在妊娠期间很常见,这些疾病是由包括体重分布、激素波动和体液平衡在内的重大生理变化引起的。这些变化通常会导致静脉曲张、血栓性静脉炎、深静脉血栓形成(DVT)、水肿、过度旋前、踝关节扭伤、跖骨痛、应力性骨折、韧带撕裂、滑膜炎、肌腱撕裂、腱鞘炎、腱膜炎、足底筋膜炎和莫顿神经瘤等疾病。本文强调了超声检查在这些疾病诊断中的应用价值,因为它具有安全性、非侵入性、实时成像能力,且无电离辐射。
超声检查在诊断静脉疾病如静脉曲张和血栓性静脉炎方面特别有效,它利用多普勒超声评估静脉结构和功能。它还可用于诊断 DVT,检测静脉扩张、反流和血栓形成。对于水肿等疾病,超声有助于区分生理和病理原因,确保准确的诊断和管理。对于过度旋前、踝关节扭伤、韧带撕裂和肌腱疾病等肌肉骨骼问题,超声可以提供软组织的详细图像,有助于进行精确诊断和有效的治疗计划。它对于检测跖骨痛、足底筋膜炎和莫顿神经瘤同样有用,可深入了解软组织异常情况,并指导治疗干预。
超声在诊断足部和踝关节的异物方面也具有重要作用,其具有高灵敏度和特异性。超声的可及性和成本效益使其成为各种医疗保健环境中非常有价值的工具,确保在妊娠期间及时、准确地诊断和管理足部和踝关节疾病,最终提高患者的治疗效果和生活质量。