Imaging-Guided Interventions in the Ankle and Foot

Image-guided injections of the foot and ankle have been traditionally performed under fluoroscopic guidance. This technique is still useful for joint injections and provides accurate documentation of the distribution of the injected material. Ultrasound has increasingly been used to guide injections of soft tissue structures in the foot and ankle such as bursae, tendon sheaths, and tendons themselves for prolotherapy, fenestration, and dry-needling techniques. Image guidance is often required for soft tissue and bone biopsy usually using ultrasound or computed tomography, respectively. The rationale and the description of the performance of these procedures are discussed and illustrated based on the author's experience.