Ultrasound-guided intervention techniques in the ankle and foot: a comprehensive guide

Ultrasound-guided interventions in the ankle and foot are safe, accurate, and effective procedures for both diagnostic and therapeutic management of soft-tissue and joint diseases. They are increasingly popular due to advances in ultrasound technology and the increasing availability of ultrasound scanners. These procedures can be performed in an outpatient setting using high-resolution scanners with high-frequency linear probes under sterile conditions, using sterile equipment, supported by standardized pre- and post-treatment protocols. Interventions include simple aspirations of bursae and ganglia; intra-articular, peritendinous, intratendinous, and ligament injections; nerve blocks; injections for Morton's neuroma; and techniques such as dry needling for plantar fasciitis and stripping or high-volume injections for non-insertional Achilles tendinopathy. While corticosteroids, anesthetics, and hyaluronic acid remain the mainstay, interest is growing in the use of platelet-rich plasma for regenerative therapy to treat ankle and foot tendinopathies, as well as in more sophisticated techniques including radiofrequency ablation and cryoablation. In this comprehensive overview, we present the latest evidence regarding possible injectates and ultrasound-guided techniques for the ankle and foot. Physicians should be aware of the full spectrum of options and supporting data to be able to provide personalized advice and targeted treatment to patients as part of a clinical radiology service.