Sonography of the first dorsal metatarsal artery of the foot

Abstract

To describe the gray-scale and Doppler sonographic examination technique and appearances of the first dorsal metatarsal artery (FDMA) of the foot and discuss its clinical significance. The dorsal arteries of foot-including the FDMA and the first plantar metatarsal artery-of 374 feet were studied using gray-scale and color Doppler sonography. Due to the difficulty of detecting the FDMA, a majority of them were identified by studying the web area just distal to the intermetatarsal space. The interosseous muscle was identified to determine the classification of the anatomic type of the FDMA. The sonographic results of 152 feet were compared with surgical findings. The average caliber of the FDMA was 1.0 +/- 0.5 mm. The FDMA was classified into 3 groups of variants based on its relationship with the first dorsal interosseous muscle. The groups were identified as the superficial artery (54.5%), intramuscular artery (39.6%), and submuscular artery (9%) variants. The rates of visualization of the distal and proximal portions of the FDMA were 86.6% and 47%, respectively. In the first intermetatarsal space, there were anastomoses between the FDMA and the first plantar metatarsal arteries in 87.6% of the feet. The FDMA varies greatly; however, sonography can clearly show its morphologic characteristics, such as caliber and location. Sonography also provides valuable preoperative information in microsurgery of the foot.