Adult Acquired Flatfoot Deformity: Anatomy, Biomechanics, Staging, and Imaging Findings
| Autor: | Catalina Mejía Gómez, Michael A. Davis, Moisés Fernández Hernando, Mini N. Pathria, Dyan V. Flores |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
musculoskeletal diseases Spring ligament Clinical Sciences Tendinosis 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Deltoid ligament Deformity Medicine Humans Radiology Nuclear Medicine and imaging Arches of the foot business.industry Foot Forefoot Anatomy medicine.disease musculoskeletal system Flatfoot Tendon Biomechanical Phenomena body regions Nuclear Medicine & Medical Imaging medicine.anatomical_structure 030220 oncology & carcinogenesis Plantar fascia medicine.symptom business human activities |
| Zdroj: | Radiographics : a review publication of the Radiological Society of North America, Inc, vol 39, iss 5 |
| Popis: | Adult acquired flatfoot deformity (AAFD) is a common disorder that typically affects middle-aged and elderly women, resulting in foot pain, malalignment, and loss of function. The disorder is initiated most commonly by degeneration of the posterior tibialis tendon (PTT), which normally functions to maintain the talonavicular joint at the apex of the three arches of the foot. PTT degeneration encompasses tenosynovitis, tendinosis, tendon elongation, and tendon tearing. The malaligned foot is initially flexible but becomes rigid and constant as the disorder progresses. Tendon dysfunction commonly leads to secondary damage of the spring ligament and talocalcaneal ligaments and may be associated with injury to the deltoid ligament, plantar fascia, and other soft-tissue structures. Failure of multiple stabilizers appears to be necessary for development of the characteristic planovalgus deformity of AAFD, with a depressed plantar-flexed talus bone, hindfoot and/or midfoot valgus, and an everted flattened forefoot. AAFD also leads to gait dysfunction as the foot is unable to change shape and function adequately to accommodate the various phases of gait, which require multiple rapid transitions in foot position and tone for effective ambulation. The four-tier staging system for AAFD emphasizes physical examination findings and metrics of foot malalignment. Mild disease is managed conservatively, but surgical procedures directed at the soft tissues and/or bones become necessary and progressively more invasive as the disease progresses. Although much has been written about the imaging findings of AAFD, this article emphasizes the anatomy and function of the foot's stabilizing structures to help the radiologist better understand this disabling disorder. Online supplemental material is available for this article. ©RSNA, 2019. |
| Databáze: | OpenAIRE |
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