The intrinsic subtalar ligaments have a consistent presence, location and morphology.

BACKGROUND: Chronic subtalar instability is a disabling complication after acute ankle sprains. Currently, the literature describing the anatomy of the intrinsic subtalar ligaments is limited and equivocal which causes difficulties in diagnosis and treatment of subtalar instability. The purpose of this study is to assess the anatomical characteristics of the subtalar ligaments and to clarify some points of confusion. METHODS: In 16 cadaveric feet, the dimensions and locations of the subtalar ankle ligaments were assessed and measured. CT-scans before dissection and after indication of the footprints with radio-opaque paint allowed to generate 3D models and assess the footprint characteristics. RESULTS: The cervical ligament (CL) had similar dimensions as the lateral ligaments: anterior length 13.9 ± 1.5 mm, posterior length 18.5 ± 2.9 mm, talar width 13.6 ± 2.2 mm, calcaneal width 15.8 ± 3.7 mm. The anterior capsular ligament (ACaL) and interosseous talocalcaneal ligament (ITCL) were found to be smaller structures with consistent dimensions and locations. CONCLUSION: This study identified consistent characteristics of the intrinsic subtalar ligaments and clarifies the local anatomical situation. The dimensions and footprints of the intrinsic ligaments of the subtalar joint suggest a more important role of the CL and ACaL in the stability of the subtalar joint. The results of this study are relevant to improve diagnostic tools and offer some guidelines when reconstructing the injured ligaments.

A Case of Postoperative Noncardiogenic Edema: Negative Pressure Pulmonary Edema.

A case of complete recovery of negative pressure pulmonary edema after a Cottle surgery in a 24-year-old male. Teaching point: Negative pressure pulmonary edema is an important cause of postoperative noncardiogenic edema, with the spontaneous disappearance of all complaints within a relatively short period.

A Case of a Mirror Image Artifact in the Forearm.

Teaching point: To emphasize the importance of recognizing mirror image artifacts in musculoskeletal ultrasound to avoid misdiagnosis, unnecessary interventions, and additional diagnostic procedures that can lead to patient anxiety, increased healthcare costs, and potential harm.

Invisible Active Bleeding Due to the Watershed Phenomenon.

A case is presented of an 83-year-old female patient with a strong suspicion of active bleeding, but no diagnostic contrast blush could be seen on the original computed tomography (CT) scan. Teaching point: When performing CT angiography in veno-arterial extracorporeal membrane oxygenation (VA-ECMO), it is important to understand the altered haemodynamics, as flow-related artefacts such as the vascular watershed phenomenon can obscure bleeding.