HSS Ultrasound Case 62

Clinical History 20 year old female with pain and crepitus over the medial aspect of the ankle upon movement of the great toe.

She has a history of fracture of the tibial shaft treated with an intramedullary rod and interlocking screws.

Ultrasound of the Month – Case 62

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Ultrasound of the Month – Case 62

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Ultrasound of the Month – Case 62

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Diagnosis: Impingement of the FHL Tendon Impingement of the FHL tendon by the proud tip of distal tibial screw causing irritation and tenosynovitis of the tendon.

Discussion MRI and ultrasound play complementary roles in assessing for complications after surgery.

Because of the outstanding soft tissue contrast and overall spatial resolution, an MRI is usually a good first line test in detecting complications such as infection, synovitis, and tenosynovitis.

Ultrasound is valuable for evaluating soft tissues, and when evaluating the positioning of hardware in relation to anatomic structures, ultrasound is not susceptible to metal artifact to the same degree that MRI is.

In addition, dynamic maneuvers on ultrasound may reveal information such as tendon subluxation or soft tissue herniation that static exams such as MRI will not detect.

Ultrasound of the Month – Case 62

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