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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