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22 mars 2010 1 22 /03 /mars /2010 17:35




ENTORSE SOUS-TALIENNE


en VARUS EQUIN


SCANNER  CT 
                    Oedème SINUS du tarse
                    Avulsion osseuse
                    disparition du ligament inter-osseux
                    épanchement liquidien


IRM           
                     Oedème sous-chondral
                      Impaction
                      Fracture


DIAGNOSTIC DIFFERENTIEL
                       Fracture de la grande apophyse du calcanéus


ASSOCIATION avec atteinte
                        Médio-pied
                        tibiofibulotalienne


LES LIGAMENTS

                      SINUS DU TARSE
                                -   LGT INTEROSSEUX TALOCALCANEEN Médial   " en haie"

                                -    LGT CERVICAL Latéral


                       LCF     LGT COLLATERAL EXTERNE Latéral  faisceau moyen


                       LCI       LGT COLLATERAL INTERNE

                              

                      



                    


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17 janvier 2009 6 17 /01 /janvier /2009 07:06

CALCANEUM   T1












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18 novembre 2008 2 18 /11 /novembre /2008 21:50
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22 février 2008 5 22 /02 /février /2008 17:53

XRAY

MEDICAL

RADIOLOGY  RADIOLOGIE RADIOLOGIA  RAYONS X

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FRACTURES THALAMIQUES  CLASSIFICATION

http://www.maitrise-orthop.com/viewPage.do?id=876



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PS   bel OS TRIGONE rétrotalaire

 

 

 

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11 février 2008 1 11 /02 /février /2008 09:28

CHEVILLE

HAGLUND's Syndrome
HAGLUND's Deformity

calcaneum

tendon d'ACHILLE 

BOURSE RETRO-CALCANEENNE

BURSITE  -

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Your answer is correct
Summary:
A 49-year-old female with recurrent, fluctuating pain and swelling around the ankle.
Diagnosis:
Haglund's syndrome.
Imaging Findings:
The lateral plain film view of the ankle demonstrates soft tissue thickening of the distal Achilles tendon, at its insertion on the posterior calcaneus, as well as soft tissue denstiy within the retrocalcaneal bursa.Sagittal and axial fat-suppressed T2-weighted images demonstrate fusiform enlargement of the distal Achilles tendon at its insertion on the posterior tuberosity of the os calcis, with heterogeneous intrasubstance signal intensity. There is an associated fluid collection in the retrocalcaneal bursa and marrow edema in the adjacent posterior calcaneus. History and imaging findings are most consistent with Haglund's syndrome.

Discussion:

Imaging findings demonstrate the typical appearance of insertional Achilles tendinitis and retrocalcaneal bursitis, a constellation of findings referred to as Haglund's syndrome, or "pump-bump." Differential considerations for these findings would include systemic inflammatory processes, such as rheumatoid arthritis, seronegative arthropathy, and gout.  
The Achilles tendon inserts onto the posterior calcaneus, with two associated bursa.
 
The bursa that lies deep to the Achilles tendon, between the Achilles tendon and the calcaneus, is termed the retrocalcaneal bursa. 
The bursa that lies superficial to the distal Achilles tendon is termed the Achilles bursa. Haglund syndrome occurs as a result of repetitive mechanical effects that cause insertional Achilles tendinitis and retrocalcaneal bursitis. Achilles bursitis may coexist. 


This condition can be seen in the patients of either sex at any age, but is most often seen in athletes and people who wear tight-fitting shoes, classically high heels.
 

Finally, Haglund's syndrome may be caused by Haglund's deformity, which is a prominent superior posterior calcaneal process, which impinges the retrocalcaneal bursa against the Achilles tendons during dorsiflexion.
   
Plain films are often sufficient in demonstrating the abnormality, as well as excluding other osseous causes of heel pain, such as calcaneal stress fracture. 

The lateral image is usually the most helpful, demonstrating thickening at the insertion of the Achilles tendon and soft tissue density in the region of the retrocalcaneal bursa. 

MR demonstrates heterogeneous thickening of the distal Achilles tendon and fluid in the retrocalcaneal and/or Achilles bursa. 
Haglund's deformity may also be identified. Erosive changes within the calcaneus should raise suspicion for a systemic inflammatory process, such as rheumatoid arthritis.
  

 

The mainstay treatment of Haglund's syndrome is conservative therapy, consisting of rest, anti-inflammatory medication, and footwear modification. Immobilization with a cast may be necessary, if activity restriction alone is insufficient. Surgery is reserved for complicated cases, including persistent or progressive symptoms despite conservative therapy or Achilles tendon rupture.   

PHOTOS CI-DESSOUS   

 
     

 

 
 
     

 

 
 
 

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