The aim of this work was to evaluate the role of ultrasonography versus other imaging modalities in cases of swollen ankle. This study included 107 cases divided into two groups. The diagnostic study group (I) (89 cases) showed that US had a high sensitivity (compared to MRI) in detecting ligament, tendon injuries, soft tissue pathologies and ankle effusion. The interventional study group (II) (18 cases), showed that US guided shock-wave therapy was an effective non invasive method for relieving heel pain accompanying bony calcaneal spurs with a mean improvement rate of 54.4%.