Normal anatomy and pathologic conditions of ankle tendons: current imaging techniques

Area of Science:

• Radiology
• Orthopedics
• Medical Imaging

Background:

• Accurate radiologic assessment of tendon injuries necessitates expertise in normal anatomy and imaging modality capabilities.
• Traditional tenography has limitations in visualizing partial ruptures and longitudinal tendon splits.
• Ultrasonography is effective for Achilles tendon ruptures and tenosynovitis but limited for other tendons.

Purpose of the Study:

• To compare the effectiveness of various radiologic modalities in diagnosing tendon injuries.
• To highlight the strengths and weaknesses of tenography, ultrasonography, computed tomography (CT), and magnetic resonance (MR) imaging for tendon pathology.

Main Methods:

• Review of the capabilities of tenography, ultrasonography, CT, and MR imaging for evaluating tendon injuries.
• Comparative analysis of imaging findings for tenosynovitis, tendinitis, tendon rupture, dislocation, and subluxation.

Main Results:

• Magnetic resonance (MR) imaging is superior to computed tomography (CT) for depicting tenosynovitis, peritendinitis, tendinitis, tendon rupture, dislocation, and subluxation.
• CT excels in visualizing calcifications and bony abnormalities associated with tendon injuries but struggles with soft tissue differentiation.
• Ultrasonography is limited in visualizing tendons beyond the Achilles tendon.

Conclusions:

• MR imaging is the preferred modality for comprehensive radiologic assessment of most tendon injuries.
• Despite advancements, differentiating between closely related conditions like tendinitis and early tendon rupture remains challenging across all modalities.
• Radiologists must be familiar with the specific strengths and limitations of each imaging technique for optimal patient diagnosis.