[Plantar plate and second ray syndrome: Normal and pathological US imaging features and proposed US classification]. / Echographie de la plaque plantaire et syndrome du 2e rayon: sémiologie normale, aspects pathologiques et proposition d'une classification échographique.

Second ray syndrome is due to degenerative changes of the plantar plate frequently associated to hallux valgus that may require dedicated surgical correction. An US classification is proposed and its impact on patient management is assessed. A total of 52 patients with hallux valgus and associated metatarsal pain scheduled for surgery were imaged. US resulted in modification of the treatment plan in 32% of patients. The surgical procedure was modified due to a plantar plate lesion not suspected on clinical and routine imaging findings. US improves the surgical management of patients with hallux valgus and second ray syndrome.

[US of the ulnal collateral ligament (UCL) at the first metacarpophalangeal (MCP) joint: a new dynamic maneuver to detect Stener lesions]. / Echographie de l'entorse du ligament collatéral ulnaire (LCU) de l'articulation métacarpo-phalangienne (MCP) du pouce: une nouvelle manoeuvre dynamique pour visualiser l'effet Stener.

Sprain of the first MCP joint is frequent. In patients with UCL tear, the adductor aponeurosis may become interposed between the distal site of ligament attachment and the ruptured ligament: this lesion, described by Stener, prevents ligamentous healing and requires surgical intervention. We present the results from a prospective study of 56 patients with first MCP sprain in order to determine the value of US by correlating with surgical findings. We propose a new dynamic maneuver during flexion-extension of the IP joint. This enables visualization of the adductor aponeurosis and its relationship to the UCL on US allowing detection of a Stener lesion when it exists. All patients with Stener lesion on US underwent surgery (32 operated patients): the sensitivity of US was 95.4% with a specificity of 80% for detection of Stener lesions. US, with the use of this specific dynamic maneuver is a reliable and reproducible tool for detecting Stener lesions. Review of video recordings allows visual comprehension of the examination for other health care providers.

[Imaging of the postoperative knee in athletes: articular cartilage, menisci, and ligaments]. / Imagerie du genou du sportif opéré: cartilage, ménisques et ligaments.

This article focuses on the common surgical procedures and reviews the clinical and imaging features of the postoperative knee following prior surgical treatment of meniscal, articular cartilage, and ligamentous injuries.

[Ultrasound of the tarsal tunnel: Normal and pathological imaging features]. / Échographie du tunnel tarsien : aspect normal et pathologique.

Tarsal tunnel syndrome is a condition that is caused by compression of the tibial nerve or its associated branches. Diagnosis is based on clinical findings but imaging is performed to exclude a cause of compression, identified in 60 to 80% of cases. Ultrasound is a useful examination because of its high spatial resolution and ability to rapidly perform an axial survey of the nerves. The ultrasound imaging features of the tarsal tunnel are described. The etiologies and different types are illustrated through a review of clinical cases.

[Evaluation of anterior knee laxity on MRI]. / Évaluation de la laxité antérieure du genou en IRM: la laxi-IRM.

PURPOSE: Evaluation of the ACL and anterior knee laxity on MR during anterior tibial translation. PATIENTS AND METHODS: Three groups were identified based on clinical and arthrometric (KT-1000) data: normal ACL (n=12), complete tear (n=10) and partial tear (n=20). MRI was performed without and with anterior tibial translation (pneumatic device) with morphological and laximetric analysis: drawer tests and dynamic evaluation of ligamentous tension. RESULTS: Intra- and inter-observer reproducibility was excellent, correlated to arthrometric data and clinical tests (Lachman, pivot shift). The difference between the drawer signs of normal subjects and patients with ACL tear was significant for a threshold value of 1,1mm for the anterior drawer (sensitivity: 93.33%, specificity: 91.7%) and 2.8 mm for the posterior drawer (sensitivity: 86.7%, specificity: 100%). Dynamic evaluation of ligamentous tension was also reproducible, statistically correlated to the MR drawer tests and reliable for the diagnosis of ACL lesions. In this preliminary study, the distinction between complete and partial ACL tears could not be detected. CONCLUSION: Anterior cruciate ligament function can be demonstrated on MR. The predictive value of this morphological and functional association should be determined in the management of patients with partial tears.