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21b - Answer: 17-year-old male presents with right foot pain

Pomeranz, Stephen
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
Includes DICOM files

HISTORY: 

This 17-year-old male presents with right foot pain since injury playing basketball one month ago.

(QUIZ ANSWER) FRACTURE HAS BEEN IDENTIFIED IN: 

Within the medial cuneiform and base of medial 1st metatarsal.

Using the 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. Subchondral low T1 signal is identified within the medial cuneiform and base of medial 1st metatarsal associated with irregularity of the overlying cartilage consistent with an osteochondral fracture. 

Increased signal is identified within the Lisfranc ligament consistent with low- to intermediate-grade sprain. No evidence of rupture or dislocation. 

The visualized tendons are without abnormality. 

The muscles of the foot are intact without evidence of hemorrhage, tear or strain. 

No soft tissue mass. 

No subcutaneous edema or swelling. 

CONCLUSION

Small, osteochondral fracture of the medial cuneiform and base of medial 1st metatarsal associated with low- to intermediate-grade Lisfranc ligament sprain. No dislocation or ligament tear.

LESSON 2, TOPIC 63

Case Challenge: Foot & Ankle MRI Cases

Case Challenge

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Content reviewed: August 31, 2021

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