Ultrasound tutorial – Flexor Hallucis Longus Ultrasound

Flexor Hallucis Longus (FHL) Ultrasound in The Foot – Technique and Findings

Positioning

• Supine or prone

Ultrasound probe for the FHL

• Hockey stick probe
  • Easiest to position
  • Good resolution
• High frequency linear probe
  • Larger field of view
  • Sometimes difficult to position optimally

Normal Appearance

• Consistent thickness
• Fascicular architecture

Pathology

• Tendinosis
  • Hypoechoic
  • Thickened
  • Loss of fascicular architecture
• Tear
  • Partial/full thickness
    • Fluid (anechoic) extends into the tear