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Lateral tarsal veins

The lateral tarsal veins are small but significant veins situated on the dorsolateral aspect of the foot, accompanying the lateral tarsal artery. They form part of the superficial and deep venous network of the dorsum of the foot and play a vital role in draining the lateral side of the foot and dorsal venous arch.

These veins collect blood from the lateral dorsal surface of the foot, communicating extensively with the dorsal venous arch, fibular (peroneal) veins, and the lateral marginal vein. The lateral tarsal veins contribute to venous return toward the small saphenous vein and the fibular deep veins, serving as an essential collateral drainage pathway.

Because of their location overlying the tarsal bones, they are prone to venous congestion, varicosities, and superficial thrombophlebitis, particularly in cases of chronic venous insufficiency or trauma.

Synonyms

  • Veins of the lateral dorsum of the foot

  • Dorsolateral tarsal veins

Origin, Course, and Termination

  • Origin: From the dorsal venous arch and venous plexuses over the lateral aspect of the foot

  • Course: Runs obliquely forward and medially across the dorsum of the foot, accompanying the lateral tarsal artery beneath the tendons of the extensor digitorum brevis and peroneus tertius muscles

  • Termination: Joins the arcuate vein on the dorsum of the foot or drains into the lateral marginal vein, which continues as the small saphenous vein posteriorly

Relations

  • Superiorly: Skin and superficial fascia of the dorsum of the foot

  • Inferiorly: Dorsal tarsal bones and interosseous fascia

  • Medially: Dorsalis pedis vein and arcuate vein

  • Laterally: Lateral marginal vein and fibular veins

Function

  • Venous drainage: Drains the lateral aspect of the dorsal foot and tarsal region

  • Collateral pathway: Communicates between superficial and deep venous systems

  • Venous return: Contributes to drainage toward the small saphenous and fibular veins

  • Clinical role: Important in venous outflow and collateral compensation during obstruction of larger deep veins

Arterial Relations

  • Accompanies the lateral tarsal artery, a branch of the dorsalis pedis artery, along the dorsum of the foot

Venous Drainage Pattern

  • Communicates with the dorsal venous arch, lateral marginal vein, and fibular veins

  • Drains into the arcuate vein or small saphenous system, depending on anatomical variation

Clinical Significance

  • Superficial thrombophlebitis: Common due to trauma, venous stasis, or infection

  • Varicosities: May form in chronic venous insufficiency

  • Venous congestion: Seen in edema, infection, or post-traumatic states

  • Imaging relevance: Important in evaluating foot venous outflow, DVT propagation, and post-thrombotic changes on MRV/CTV

MRI Appearance

  • T1-weighted images:

    • Normal veins: intermediate signal lumen surrounded by bright subcutaneous fat

    • Flowing blood: usually low signal, but slow flow appears bright due to flow-related enhancement

    • Thrombosed vein: intermediate-to-bright signal filling defect

    • Excellent for identifying venous anatomy within fatty dorsal tissue

  • T2-weighted images:

    • Normal veins: intermediate-to-dark signal

    • Slow venous flow: may appear bright (slow-flow artifact)

    • Thrombosed veins: bright signal in acute phase; dark organized signal in chronic cases

    • Helpful in assessing perivenous edema or inflammation

  • STIR:

    • Normal: low to intermediate signal

    • Slow flow or thrombus: bright hyperintense signal

    • Detects soft-tissue edema, cellulitis, or venous wall inflammation

  • Proton Density Fat-Saturated (PD FS):

    • Normal: dark round lumens within bright fat

    • Slow flow: appears bright

    • Thrombosed segments: bright intraluminal signal

    • Excellent for early DVT and perivenular inflammation

  • T1 Fat-Sat Post-Contrast:

    • Normal: uniform enhancement of venous lumen

    • Thrombus: non-enhancing filling defect within enhanced fat

    • Slow flow: may enhance gradually during delayed imaging

    • Inflamed vein wall: enhances brightly (thrombophlebitis)

MR Venography (MRV) – Contrast Enhanced

  • Technique: Gadolinium-enhanced or time-resolved MRV of the foot and ankle

  • Normal veins: Smooth, thin-walled enhancing channels over the lateral dorsum of the foot

  • Thrombosis: Appears as non-enhancing intraluminal defect or abrupt venous cutoff

  • Slow flow: Gradual, patchy enhancement over sequential phases

  • Varicosities: Tortuous enhancing superficial venous channels

  • Utility: Best for assessing foot venous drainage, small-vessel thrombosis, and superficial venous disease

CT Appearance

Non-Contrast CT:

  • Veins not well visualized directly

  • May appear as tiny soft-tissue densities lateral to the tarsal bones

  • Indirect findings: fat stranding, edema, or calcified chronic thrombus

Post-Contrast CT (CT Venography – CTV):

  • Normal: Thin enhancing venous channels along the lateral dorsum of the foot

  • Thrombosis: Intraluminal filling defect or non-opacified segment

  • Varicosities: Tortuous, dilated, enhancing veins

  • Perivenous inflammation: Enhanced perivascular fat and wall thickening

  • Slow flow: Delayed opacification or patchy contrast filling

MRI images

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

MRI images

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

MRI images

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

MRI image

Lateral tarsal veins of foot coronal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

MRI image

Lateral tarsal veins of foot coronal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000_00001