Musculoskeletal Ultrasound in Common Foot and Ankle Pathologies

Background: Musculoskeletal ultrasound has been performed since the early 1970s, but a perceived high level of “operator dependence” limited its expansion into orthopaedic surgery. Recent advancements in hardware and image processing have given rise to lightweight portable machines capable of detailed examination of superficial bony and soft-tissue structures. This portability, coupled with other ultrasound advantages such as allowing dynamic, real-time, and functional evaluations without radiation exposure has stimulated interest in the use of ultrasound by orthopaedic surgeons. Methods: This review examines the use of musculoskeletal ultrasound in the foot and ankle by the orthopaedic surgeon in the areas of tendon pathology, heel pain, inflammatory conditions, nerve pathology, fractures, sprains, and ultrasound-guided interventions. Results: Musculoskeletal ultrasound has numerous advantages over standard imaging techniques in the diagnosis and treatment of musculoskeletal pathology. Musculoskeletal ultrasound fails, however, to adequately image deep pathologies in obese patients and joints hidden by bones. Conclusion: Musculoskeletal ultrasound has many applications and it is necessary to continue the research of this imaging technology in other orthopaedic fields.