, Volume 10, Issue 1, pp 92-97
Date: 18 Oct 2013

Symptomatic Bipartite Medial Cuneiform Treated with Fluoroscopic and Ultrasound-Guided Injections

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Introduction

The bipartite medial cuneiform (BMC) is a rare congenital variant that was first described by Morel in the 18th century [2, 6]. Amongst the many causes of midfoot pain, BMC is primarily an imaging diagnosis that often depends on plain radiographs as the initial diagnostic test. Recognizing a BMC on radiographs can be difficult as the osseous segments are typically well corticated and blend with the remainder of the tarsal bones. Additionally, although there are many fracture patterns at the tarsometatarsal (TMT) joint level including Lisfranc injuries, the cleft between the osseous segments lies in the horizontal plane in contrast to the typical vertical orientation of isolated fractures through the medial cuneiform [9]. The cleft is formed by a pseudoarticulation between the osseous segments. Symptomatic patients typically present with chronic midfoot pain that is exacerbated with ambulation or acute injury typically due to the inherent instability of the pseudoarticulatio