Case Challenge

Foot & Ankle

Stephen J Pomeranz

Gain confidence interpreting Foot & Ankle MRI Cases with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME. Try it free!

Case Review

Musculoskeletal (MSK)

Post-Course Activities

This Power Pack is comprised of 25 unique Foot / Ankle MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Foot & Ankle MRI Cases

Case 23 - 61-year-old female presents with left foot pain

<div>HISTORY:&#160;This 61-year-old female presents with left foot pain after a fall.(QUIZ ANSWER) NOT A FINDING IN THIS CASE:&#160;Lisfranc ligament tear.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: The bones are in anatomic alignment. Low T1 signal is identified at the base of the 1st metatarsal, multidirectional associated with extensive osteoedema consistent with a comminuted fracture. Abnormal marrow signal and osteoedema are also seen within the bases of the 3rd and 4th metatarsals as well as within the cuboid consistent with microtrabecular fractures. Additional fractures are also noted within the distal shafts just below the heads of the 2nd, 3rd and 4th metatarsals. Dorsal angulation of the 2nd metatarsal fracture is seen. Subtle abnormal marrow signal and osteoedema are also seen within the proximal phalanx of the 1st digit concerning for an additional microtrabecular fracture.&#160;The Lisfranc ligament is intact. The plantar Lisfranc ligament is inflamed concerning for sprain. Edema of the intermetatarsal ligaments noted concerning for sprain. Moderate edema of the 2nd and 3rd intertarsal ligaments also noted consistent with sprain. No evidence of dislocation.A bipartite tibial sesamoid is incidentally noted.The visualized tendons are without abnormality. No tendinopathy or tendon tear.&#160;Mild muscle atrophy of the interosseous muscles noted. No evidence of hemorrhage, tear or strain.&#160;No soft tissue mass.&#160;Diffuse subcutaneous edema noted about the foot.&#160;CONCLUSION:&#160;1. Comminuted fracture of the lateral base of the 1st metatarsal, microtrabecular fractures of the 3rd and 4th metatarsals as well as the cuboid and fractures of the distal shafts just below the heads of the 2nd, 3rd and 4th metatarsals with dorsal angulation of the 2nd metatarsal.&#160;2. Lisfranc ligament intact without dislocation; however, intermediate grade sprains of the plantar Lisfranc ligament, the intermetatarsal and the 2nd and 3rd intertarsal ligaments.&#160;3. Microtrabecular fracture of the proximal phalanx of the 1st digit.&#160;4. Interosseous muscle atrophy.&#160;5. Moderate subcutaneous edema.</div>

Case

Comminuted fracture of the lateral base of the 1st metatarsal

Microtrabecular fractures of the 3rd and 4th metatarsals

Which of the following is NOT a finding in this case?