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Wk 8, Case 2, Foot/Ankle MR - Review

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Report

Patient History

15F Right foot pain. No known injury.

Findings

ARTICULATIONS:

Bone: Nondisplaced microtrabecular stress fracture involving the entire navicular bone and the adjacent proximal pole of the lateral cuneiform (C3). Diffuse osteoedema and surrounding soft tissue swelling. No osteonecrosis.

Hindfoot: No arthropathy.

Midfoot: No arthropathy.

Lisfranc Joint: The Lisfranc joint is intact, without fracture or joint space widening.

Forefoot: No prominent forefoot arthrosis. No evidence of hallux valgus deformity.

LIGAMENTS:

Lisfranc Ligament: Intact.

Collateral Ligaments: Chronic small avulsion injury and dystrophic ossification of the calcaneonavicular ligament part of the bifurcate ligament with associated osteoedema.

TENDONS:

Peroneus Longus/Brevis: Intact.

Posterior Tibialis: Intact.

Flexor Compartment: Intact.

Extensor Compartment: Intact.

Plantar Plate: Normal.

GENERAL:

Muscles: No traumatic muscle injury. No volumetric muscle atrophy.

Soft Tissue: Mild dorsal soft tissue swelling overlying the mid and forefoot.

Plantar Fascia: No thickening, tearing, inflammatory changes or enthesopathy formation.

Joint Effusion: Small tibiotalar joint effusion.

Intra-Articular/Loose Bodies: None.

Impressions

1. Nondisplaced microtrabecular stress fracture involving the entire navicular bone and the adjacent proximal pole of the lateral cuneiform (C3).

2. Small avulsion injury and dystrophic ossification of the calcaneonavicular ligament, part of the bifurcate ligament. Lateral limb of the bifurcate ligament likely torn.

3. Small tibiotalar joint effusion.

4. Mild dorsal soft tissue swelling overlying the mid and forefoot.

Case Discussion

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Gitanjali Bajaj, MD

Assistant Professor

University of Arkansas for Medical Sciences

Edward Smitaman, MD

Clinical Associate Professor

University of California San Diego

Brian Y. Chan, MD

Assistant Professor of Musculoskeletal Radiology

University of Utah

Tags

Musculoskeletal (MSK)

MRI

Foot & Ankle

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