HOW TO USE ANATOMICAL LANDMARKS IN POSITIONING OF THE SONOGRAPHY SENSOR IN ANKLE JOINT EXAMINATION

Abstract

In the structure of ankle joint trauma the damage of ligaments prevailed and could take up to 70–75 % of all damages of this region. Today, the "gold standard" in the examination of the ligaments damage is considered to be MR I which has the sensitivity of 90 % and specificity of 83 %. However, the limited availability of MR I and the high cost of the research do not allow this method to be included in the diagnostic measures algorithm in case of ankle joint ligaments damage. The available imaging techniques of the ankle joint ligament traumas are sonography. However, anatomical peculiarity of the ankle joint ligaments makes the sonography procedure complicated and still is remains the subject of discussion in foreign scientific literature up to date. The aim of the study – to establish of the optimum position of the sonographic sensor using anatomical landmarks for clear visualization and have ultrasound evaluation of the relationships in the ankle joint in the young patients. Materials and Methods. The study involved 36 young people, among them – 19 men and 17 women with average age of (21.3±1.26) years. A simultaneous sonographic examination of both joints was performed. 72 joint were examined in total. The examination was conducted using apparatus Aloka SSD 2000 with the usage of high-frequency wideband sensor and operating frequency of 7–12 MH z. Ankle joint was investigated in four sensor positions: coronal, sagittal, posterior and axial. As anatomical landmarks were used articular cavity of the ankle joint, the front and the back edge of a lateral malleolus, greater and lesser tubercle of a medial malleolus. Results and Discussion. On the echograms, the connections of the ankle joint were identified as hypoechoic, fibrillar structures with properties of anisotropic effect. The severity of the anisotropic effect depended on the angle of the sensor position relative to the ligament. The results obtained during the sonography show the expediency of introducing into the daily practice of ultrasound diagnostic method in order to identify the damage of the connective structures of the ankle joint. Conclusions. Data that was received in the study indicates the feasibility of implementing the sonographic techniques in the examination of ankle joint ligaments damage in the daily practice. Knowledge of normal anatomy and positioning of sonography sensor using anatomical landmarks has a significant meaning for optimal evaluation of examined joint structures.

Keywords

• травма
• ушкодження
• зв’язки
• надп’ятково-гомілковий суглоб
• анатомія
• сонографія.