Ankle and foot complaints: musculoskeletal ultrasound evaluation compared to clinical assessment

The ankle and foot joints are frequently affected by rheumatic and musculoskeletal disorders (RMDs) at all ages, causing pain and limited movement. Ultrasound (US) is an effective tool for assessing soft tissue and monitoring patients with inflammatory and degenerative RMDs.

To examine the frequency and classifications of soft tissue lesions, including tenosynovitis, tendon injuries, and ligament damage, as well as synovitis in the ankle and foot, clinically and with ultrasound evaluation in patients presenting associated symptoms.

A cross-sectional study at two centers of rheumatology, including clinical examination of patients with ankle and/or foot complaints. Ultrasound evaluation included B-mode gray scale, and power Doppler was done. Functional assessment of ankle and foot was performed by the Foot Function Index.

A study of 200 ankles and feet were examined in100 patients with rheumatoid arthritis (34%), spondylarthritis (23%), and undiagnosed cases (16%). Joints were more affected than tendons or ligaments, notably the metatarsophalangeal (83%), talonavicular (63%), subtalar (46%), and tibiotalar (35%) joints. The Achilles tendon was most affected in both rheumatoid arthritis and spondylarthritis patients.

Subclinical diagnosis and differentiation using ultrasound for ankle and foot pathologies were proven and correlated significantly with patients' function and disability. Key Points • Musculoskeletal US has a beneficial effect in the evaluation of ankle and foot complaints. • The physical activity is severely impacted by the ankle-foot manifestations.