Etiology, Pathophysiology, and Most Common Injuries of the Lower Extremity in the Athlete  Patrick R. Burns, DPM, Nicholas Lowery, DPM  Clinics in Podiatric Medicine and Surgery  Volume 28, Issue 1, Pages 1-18 (January 2011) DOI: 10.1016/j.cpm.2010.11.003 Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 1 Magnetic resonance imaging (MRI) examples of normal (A) and torn (B) anterior talofibular ligament, and normal (C) and torn (D) Lisfranc ligament after sprain injuries. Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 2 Radiographic (A) and MRI (B) examples of osteochondral lesion of the talus after sprain. Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 3 Clinical pictures of ecchymosis associated with classic sprain. Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 4 (A, B) Clinical pictures of anterior drawer examination. Note loss of skin lines and puckering of lateral ankle corresponding to anterior talofibular ligament insufficiency. Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 5 MR image of ankle sprain immediately following injury. Note subcutaneous edema without more extensive pathology. Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 6 Arthroscopic images in patients with sprain history. Note acute synovitis (A), loose body (B), and Bassett (C). Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 7 Radiographic example of Lisfranc injury: non–weight bearing (A) and weight bearing (B). Note the subtle difference in the space near the base of the first and second metatarsals. Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 8 Intraoperative example of stress view (A) for Lisfranc injury and subsequent placement of screws for open reduction/internal fixation (B) corresponding to areas of instability. Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 9 Example of radiographic (A) and MRI (B) findings of acute-on-chronic Achilles tendinosis. Note the thickening in the watershed area. Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 10 Clinical pictures of Achilles tendon surgery with (A) and without (B) wound complications. Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 11 Example of acute Achilles tendon rupture (A) and primary repair (B). Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 12 MRI example of shallow retromalleolar groove with low-lying muscle (A) and subsequent deepening procedure (B). Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 13 MRI examples of high risk stress fractures: navicular (A), talar neck (B), and sesamoid (C). Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 14 Postoperative images of calcaneal osteotomy (A) and revision of recurrent fifth metatarsal stress fracture (B). Calcaneal osteotomy was performed to reduce stress to the lateral column. Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 15 Computed tomograph (A) and postoperative radiographs (B) of navicular stress fracture repair. Note the sclerosis and depth of the fracture preoperatively. The repair was made with distal tibial autograft and a dorsal plate to resist further tension. Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 16 Example of a typical Jones fracture (A) and intramedullary screw fixation (B). Clinics in Podiatric Medicine and Surgery 2011 28, 1-18DOI: (10.1016/j.cpm.2010.11.003) Copyright © 2011 Elsevier Inc. Terms and Conditions