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Lateral tarsal artery

The lateral tarsal artery is a branch of the dorsalis pedis artery that supplies the lateral aspect of the dorsum of the foot. It runs obliquely laterally and distally beneath the tendons of the extensor digitorum brevis and extensor hallucis brevis, providing blood supply to these muscles, the tarsal bones, and the overlying skin.

It plays a crucial role in maintaining perfusion of the anterolateral foot and contributes to the dorsal arterial arch through anastomoses with the arcuate artery and lateral plantar artery. Damage or occlusion can result in ischemic changes to the dorsum of the foot, especially in diabetic or peripheral vascular disease patients.

Synonyms

  • Arteria tarsalis lateralis

  • Lateral dorsal foot artery

  • Lateral branch of dorsalis pedis

Origin, Course, and Branches

  • Origin: Arises from the dorsalis pedis artery, usually opposite the navicular bone or the base of the first metatarsal.

  • Course: Passes obliquely laterally and distally, beneath the tendons of the extensor digitorum brevis and extensor hallucis brevis, across the tarsal bones.

  • Termination: Ends by anastomosing with the arcuate artery and lateral plantar artery to form part of the dorsal arterial network.

  • Branches: Small muscular branches to the extensor digitorum brevis and extensor hallucis brevis; cutaneous branches to the dorsum of the foot; articular twigs to tarsal bones and joints.

Relations

  • Superiorly: Tendons of extensor digitorum brevis and extensor hallucis brevis

  • Inferiorly: Dorsal surfaces of tarsal bones and interosseous fascia

  • Medially: Dorsalis pedis artery at its origin

  • Laterally: Arcuate artery and lateral plantar artery connections

Arterial Supply

  • The lateral tarsal artery itself supplies:

    • Extensor digitorum brevis

    • Extensor hallucis brevis

    • Tarsal joints

    • Lateral dorsal skin and fascia

    • Contributes to the dorsal arterial arch through anastomosis with lateral plantar and arcuate arteries

Function

  • Perfusion: Provides oxygenated blood to lateral dorsal structures of the foot

  • Collateral circulation: Connects dorsal and plantar arterial systems

  • Clinical importance: Key vessel during dorsalis pedis flap surgeries and in vascular assessment of the foot

Clinical Significance

  • Ischemia: Occlusion or stenosis may lead to lateral foot ischemia, ulcers, or delayed wound healing

  • Trauma: May be injured during dorsal foot lacerations or surgical incisions

  • Vascular grafting: Sometimes used as a recipient vessel in microvascular reconstruction

  • Imaging importance: Frequently evaluated in angiography for peripheral arterial disease and foot ischemia

MRI Appearance

  • T1-weighted images:

    • Artery lumen: flow void (black line) due to fast-flowing blood

    • Surrounding fat and soft tissues: intermediate to bright

    • Arterial wall thickening or thrombosis may appear as intermediate-to-bright signal within vessel lumen

  • T2-weighted images:

    • Normal vessel: flow void (dark tubular structure)

    • Occluded or slow-flow vessel: may appear bright (hyperintense) due to static blood or thrombus

    • Helps identify inflammation, thrombosis, or perivascular edema

  • STIR:

    • Suppresses fat around vessel, making vascular wall and edema appear bright

    • Useful for evaluating arteritis or perivascular inflammation

  • Proton Density Fat-Saturated (PD FS):

    • Enhances contrast between artery and surrounding tissues

    • Vessel wall changes or soft-tissue edema appear bright, with normal vessel lumen remaining dark

  • T1 Fat-Sat Post-Contrast (Axial):

    • Normal artery: brilliant enhancement of vessel lumen with smooth, well-defined margins

    • Occlusion: non-enhancing lumen with possible peripheral mural enhancement

    • Perivascular enhancement may indicate inflammatory vasculitis or infection

    • Excellent for assessing arterial patency and collateral flow in the dorsal foot

MRA (Contrast-Enhanced Magnetic Resonance Angiography)

  • Provides high-resolution visualization of the lateral tarsal artery and its branches

  • Normal findings: Continuous, smooth, enhancing tubular structure branching from the dorsalis pedis artery

  • Abnormal findings:

    • Stenosis: Focal or segmental narrowing with reduced enhancement

    • Occlusion: Absence of flow-related enhancement in the expected arterial course

    • Collateral vessels: Small enhancing channels adjacent to the occluded segment

  • Best sequences: 3D contrast-enhanced MRA and Time-of-Flight (TOF) MRA

CTA (Computed Tomography Angiography)

  • Normal appearance:

    • Lateral tarsal artery visualized as a thin, enhancing vessel lateral to the dorsalis pedis artery

    • Clear continuity with arcuate and lateral plantar arteries

    • Surrounding tarsal bones and tendons well defined

  • Abnormal appearance:

    • Stenosis: Focal luminal narrowing with post-stenotic dilatation

    • Occlusion: Non-enhancing vessel segment with abrupt cut-off

    • Aneurysm or pseudoaneurysm: Focal saccular outpouching with intense enhancement

    • Atherosclerosis: Irregular luminal contour or calcification within vessel wall

  • Post-Contrast Evaluation:

    • Artery enhances brightly relative to muscle and fascia

    • Timing of contrast bolus critical for clear delineation of distal branches

    • CTA provides excellent correlation with MRA and Doppler findings for vascular assessment

MRI images

Lateral tarsal artery axial cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

MRI images

Lateral tarsal artery axial cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000_00001

MRI images

Lateral tarsal artery axial cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000_00002

MRI images

Lateral tarsal artery axial cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000_00003

CT images

Lateral tarsal artery ct axil 1

CT images

Lateral tarsal artery ct axil 2