Rheumatic diseases of the ankle joint and tarsus

Diseases of the hindfoot are associated with considerable functional impair ment and therefore may hamper patients' movements during gait considerably. Because of biomechanical overload, articular structures, tendons and ligam ents are prone to early degenerative changes during the course of rheumatic diseases as visible with plain film radiography, sonography (US), or magne tic resonance imaging (MRI). Findings may occur as arthritis of major joint s or in the form of fibroostitis and bursitis of the os calcis. Despite the progressive course of rheumatic diseases and characteristic imaging findin gs, high variability of X-ray signs may occur. Plain film radiograms and hi gh resolution ultrasonography play a key role in imaging rheumatic diseases of the hindfoot. MRI supports imaging diagnosis in selected cases. The pri ncipal goals of diagnostic imaging are precise and reproducible documentati on of morphologic abnormalities and differentiated analysis for planning pr oper conservative or surgical treatment.