Postoperative Ankle

Ankle and foot treatment approach has changed dramatically over the past years. Thus radiologists are being asked more frequently for postoperative imaging. Knowledge of the different surgical techniques is key to be able to differentiate the normal postsurgical appearance from complications. Clinical symptoms and the interval since surgery are essential information to evaluate the ankle and foot accurately after surgery.

Plain films are still the first imaging technique, but computed tomography (CT), ultrasonography, and magnetic resonance (MR) imaging are valuable techniques to rule out complications. Tailored MR protocols with metal reduction sequences are needed to reduce artifacts and increase our diagnostic ability.

This issue begins with the evaluation of different groups of calcaneal and talus fractures. Dr. Alexandra Piña-Rivas and colleagues, and Thibault Willaume and Guillaume Bierry, will provide an overview of these frequent fractures. Plain films and CT are the best imaging modalities for their evaluation. In great detail the fracture characteristics required for their management are being reviewed. Early and late complications are described, such as infection, nonunion, and some specific complications.

The concept of ankle instability and microinstability has recently changed with new anatomical developments. A surgical approach with new arthroscopic repair options is performed more often, and radiologists need to be aware of them. Alexys Perez and colleagues review the latest lateral and medial ankle ligament injuries.

Osteochondral lesions of the talar dome are a frequent cause of ankle pain. Pre- and postoperative evaluation is reviewed by James Francis Griffith et al, including how to optimize MRI protocols for high-resolution imaging, including ankle traction and small field-of-view coil imaging.

Ankle tendon disorders are usually related to overuse with many predisposing factors. A peroneal tendon lesion is an important cause of ankle pain and instability. Cross-sectional imaging provides accurate pre- and postoperative evaluation. In the medial compartment, posterior tibialis tendon injuries and flexor tendon pre- and postsurgical imaging are reviewed by Ralph Abou Diwan and colleagues.

Plantar fascia contributes to the longitudinal arch of the foot. In his article, Luis Beltran reviews normal anatomy, lesions of the plantar fascia, different surgical options, and postsurgical imaging.

Forefoot lesions are described in two articles: the evaluation of the plantar plate and turf toe by Simon Dimmick et al and Morton's neuroma by Marco Zanetti and Nadja Saupe, with a fine description of MR appearance after surgical ligament repair and Morton's neuroma resection.

The distinction between neuroarthropathy and osteomyelitis is still challenging despite the multiple diagnostic imaging modalities available. Posttreatment imaging is even more difficult. James Teh et al review key points to differentiate Charcot foot from infection.

Soft tissue tumors, especially benign lesions, are frequent in the foot and ankle, such as plantar fibromatosis, tenosynovial giant cell tumors, chondromatosis, or neural tumors. They are reviewed in the article from Iris-Melanie Noebauer-Huhmann and colleagues, together with sarcomas, with an emphasis on posttherapeutic changes and complications.

In the article by Christopher J. Burke and colleagues, percutaneous interventional procedures are provided as an alternative to surgical techniques with lower risks and morbidity. Injection, aspirations, biopsies, and ablation techniques are discussed.

Finally, the spectrum of pathologic conditions of the pediatric foot and ankle are described by Maria Pilar Aparisi Gómez et al. Although postsurgical evaluation is based on clinical assessment and plain films, in some conditions additional imaging techniques are needed.

I would like to thank all the authors of this issue for their excellent work, offering us a review of the most up-to-date surgical techniques and their postoperative appearance. I also want to express my gratitude to the editors of Seminars for offering me the opportunity to act as guest editor.

Publication History

Article published online:
15 February 2023