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9 downloadsThis model is the left foot and ankle skin rendering of a 65-year-old male with left thigh myxoid fibrosarcoma. At the time of diagnosis, the patient had metastases to his lungs. The patient therefore underwent neoadjuvant radiotherapy, surgery, and adjuvant chemotherapy and was found to have an intermediate grade lesion at the time of diagnosis. The patient unfortunately died 9.5 months after diagnosis. This is an STL file created from DICOM images of his CT scan which may be used for 3D printing. Topographical landmarks of the foot and ankle consist of muscular, tendinous, and bony structures. Proximally, the superficial muscles of the anterior (tibialis anterior), lateral (peroneals) and posterior (gastrocnemius) compartments may be palpated. Anteriorly, the tibialis anterior tendon crosses the ankle joint and is used as a landmark for ankle joint injections and aspirations, where the practitioner will place the needle just lateral to the tendon. Posteriorly, the gastrocnemius and soleus converge to form the Achilles tendon. Ruptures of the tendon as well as tendinous changes due to Achilles tendinopathy may be palpated. At the level of the ankle joint, the joint line, medial malleolus (distal tibia) and lateral malleolus (distal fibula) may be palpated. The extensor hallucis longus and extensor digitorum longus tendons are visible at the surface of the dorsal foot. The extensor digitorum brevis muscle belly is seen on the dorsum of the lateral foot. On the plantar foot, the plantar fascia may be palpated. Nodules associated with plantar fascial fibromatosis may be palpated here. Plantar fasciitis is also diagnosed when pain is associated with palpation of the insertion of the plantar fascia on the medial heel. Other common pathologies on the plantar foot are ulcerations associated with diabetic neuropathy and other neuropathic conditions. This model was created from the file STS_023.
42 downloadsThis model is the left foot and ankle bone rendering of a 65-year-old male with left thigh myxoid fibrosarcoma. At the time of diagnosis, the patient had metastases to his lungs. The patient therefore underwent neoadjuvant radiotherapy, surgery, and adjuvant chemotherapy and was found to have an intermediate grade lesion at the time of diagnosis. The patient unfortunately died 9.5 months after diagnosis. This is an STL file created from DICOM images of his CT scan which may be used for 3D printing. The ankle is a hinge (or ginglymus) joint made of the distal tibia (tibial plafond, medial and posterior malleoli) superiorly and medially, the distal fibula (lateral malleolus) laterally and the talus inferiorly. Together, these structures form the ankle “mortise”, which refers to the bony arch. Stability is provided by the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL) laterally, and the superficial and deep deltoid ligaments medially. The ankle is one of my most common sites of musculoskeletal injury, including ankle fractures and ankle sprains, due to the ability of the joint to invert and evert. The most common ligament involved in the ATFL. Radiographic analysis of an ankle after injury should include the so-called “mortise view”, upon which measurements can be made to determine congruity of the ankle joint. Normal measurements include >1 mm tibiofibular overlap, </= 4mm medial clear space, and <6 mm of tibiofibular clear space. The talocrural ankle is measured by the bisection of a line through the tibial anatomical axis and another line through the tips of the malleoli. Shortening of the lateral malleolus can lead to an increased talocrural angle. The foot is commonly divided into three segments: hindfoot, midfoot, and forefoot. These sections are divided by the transverse tarsal joint (between the talus and calcaneus proximally and navicular and cuboid distally), and the tarsometatarsal joint (between the cuboids and cuneiforms proximally and the metatarsals distally). The first tarsometatarsal joint (medially) is termed the “Lisfranc” joint, and is the site of the Lisfranc injury seen primarily in athletic injuries. This model was created from the file STS_023.