Figure 1
Ultrasound of the left foot. Sagittal view (A). There is a normal thickness of the plantar fascia between 2 and 4 mm (arrow). Tubular, hypoechoic structures are seen near the plantar fascia. Coronal view (B) with compression and color Doppler imaging. These structures are not compressible, and there is no blood flow. The thrombus (arrow) is located deeply and medially to the plantar artery (arrowhead) and between the musculus (m.) flexor digitorum brevis (1) and m. abductor hallucis (2). Sagittal view with color Doppler imaging (C). The thrombi (B-C) are located deeply beneath the medial plantar artery (arrow).
Figure 2
MRI of the left foot. Coronal reformatted T2-WI FS (A) showing subtle intramuscular edema (arrow) adjacent to the medial plantar veins. The thrombosed vein itself is not visible. Medially from the medial plantar artery and veins is the m. abductor hallucis (1); laterally the m. flexor digitorum brevis (2); and deeply beneath is the m. quadratus plantae (3). Sagittal reformatted T1-weighted subtraction image after gadolinium (B). There is a filling defect in the medial plantar veins (arrows) with a thin sleeve of hyperintense contrast around the thrombus.
Figure 3
Position of the ultrasound probe for visualization of the medial plantar veins in a coronal plane. To visualize the medial plantar veins in a sagittal plane, the probe is turned 90° in a longitudinal direction on the foot.
Figure 4
MRI of the left foot in a normal patient for comparison. Coronal reformatted T2-WI showing clearly the hyperintense medial plantar veins (arrow) in normal conditions. The veins are surrounded by the m. abductor hallucis (1) medially; the m. quadratus plantae (2) deeply from the veins; and the m. flexor digitorum brevis (3) laterally. The muscle belly of the m. abductor digiti minimi (4) is located at the lateral plantar aspect of the foot.