Ankle & Foot Ultrasound Guided Injections

Ultrasound's ability to accurately image large numbers of anatomical structures, in short durations and with different joint positions makes it the perfect diagnostic tool for ankle & foot pain...

Ankle & Foot Diagnostic Ultrasound Scan

The Anatomy of a Ankle & Foot Ultrasound Scan

The ankle and foot anatomy contains large tendon structures such as the Achilles tendon as well as multiple small joints across the midfoot toes. Many of the tendons also run in conjunction with nerves in specified neurovascular tunnels as they cross the ankle. Diagnostic ankle and foot imaging excellent way of how to assess the majority of and such pain conditions affecting these anatomical structures

The Achilles tendon is affected with inflammation and painful thickened areas and less commonly may suffer with tears to the body of the Achilles tendon. Ultrasound imaging is the gold standard modern imaging form to evaluate extent and size of areas of Achilles tendinopathy as well as evaluate location and measurements of Achilles tendon tears, crucial to rising on appropriate management pathways. 

Other tendons such as the peroneal tendons which (located at the outer aspect of the ankle and foot) and the medial ankle tendons including the tibialis posterior tendon, may also suffer with tendinopathy and inflammation of the tendon sheath (known as tenosynovitis). An ankle and foot ultrasound can diagnose these conditions with optimal accuracy.

The joints of the midfoot and toes may suffer with degenerative osteoarthritis. Changes at these joints are accurately assessed on ultrasound imaging before any changes on other forms of imaging such as x-rays and MRI scans. 

Furthermore, the forefoot ultrasound scanning are able to detect "neuroma's" - thickening and pain to digital nerves as well as any fluid and inflammation to the cushions (intermetatarsal bursae) which lie between our toes.

Types of Ankle & Foot Ultrasound Guided Injections

Ankle & Foot Joint Ultrasound Guided Injections

Ankle and foot injections can be performed for a wide variety of musculoskeletal conditions. Intra-articular ankle and foot joint injections are often performed due to degenerative changes at the respective joint (osteoarthritis). joints which are commonly injected under ultrasound guidance include:

The ankle joint is technically known as the talo-crural joint and has a coupled joint known as the subtalar joint which together produce the movements at the rear foot. In many cases of an ankle sprain either one of these joints may not settle adequately and may remain painful and swollen. An intra-articular ankle talocrural or intra-articular ankle subtalar joint may be considered in these circumstances.

Tendon Ultrasound Guided Injections of the Ankle & Foot

Tendon issues around the outer aspect of the ankle (closed) may occur due to trauma following repetitive use injuries. Similarly,  the medial ankle tendons and in particular the tibialis posterior tendon may also suffer from traumatic injury or overuse injuries. Many times an ankle or foot injection (under ultrasound guidance) will target the interface between the tendon and tendon sheath to reduce ongoing inflammation. Ankle and foot tendon injections commonly performed include:

Lastly, heel pain also known as plantar fasciitis which has not responded to adequate rehabilitation and customised orthosis management may also be treated with an ultrasound guided corticosteroid or platelet-rich plasma heel injection. 

Forefoot Ultrasound Guided Injections

A toe injection is normally used to target degenerative osteoarthritis of the toe joints.  However, on occasion toe joints may remain painful and swollen after a trauma such as stubbing the toe. In this circumstance a toe joint intra articular injection can also provide excellent pain relief and help to restore range of movement in the long-term.

Another type of toe injection is used to relieve the symptoms of Morton's neuroma which is a swelling of the interdigital nerves between the toes. When combined with appropriate footwear modification and orthoses management in the long-term, an ultrasound guided steroid injection to the affected toes is extremely effective.