Sonographic imaging and assessment of the sural nerve

The sural nerve is a sensory nerve which innervates the posterolateral distal calf and lateral foot. It can be demonstrated using high resolution ultrasound and travels near the small saphenous vein throughout most of its course. There are variations in its origin and relative position through the posterior distal calf, lateral ankle, and foot. To allow this nerve and any potential pathology or injury to be sonographically demonstrated, a good understanding of the sonographic relative anatomy, course, and common anatomical variations, as well as the sonographic normal appearances throughout need to be appreciated and these are reviewed in this paper.