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MRI of lesser metatarsophalangeal joint plantar plate tears and associated adjacent interspace lesions

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Abstract

Objective

To identify the variety of second and third intermetatarsal space (IS) lesions that may coexist with and without adjacent metatarsophalangeal joint (MTP) plantar plate (PP) tears.

Materials and methods

One hundred forefoot MRIs in 96 patients with metatarsalgia obtained between 30 September 2011 and 21 July 2012 using 1.5- or 3-T MRI were retrospectively reviewed in consensus by two MSK radiologists and one podiatrist (DPM). MRI was evaluated for second and third MTP PP tear and the presence/nature of second and third IS lesions. Second and third IS neuromas were measured in transverse (trans) dimension.

Results

A total of 40 PP tears were identified: 36 at the second and 4 at the third MTP. Second MTP PP tear was identified in 33 % of females and 40.5 % of males. In the 63 female feet there were 21 second MTP PP tears, all of which also had second IS lesions: pericapsular fibrosis (16), bursitis (4), and ganglion (1). In the 37 male feet there were 15 second MTP PP tears, 14 of which had second IS lesions: pericapsular fibrosis (8), bursitis (5), and ganglion (1). There was no definite second IS neuroma adjacent to any second MTP PP tear. In females without PP tear, there were 24 second (3 mm trans average) and 43 third IS neuromas (4.1 mm trans average). In males without PP tear, there were 9 second (3.4 mm trans average) and 16 third IS neuromas (4.1 mm trans average).

Conclusions

MTP PP tears occurred in 40 % of our cases, 90 % of which occurred at the second MTP. Almost all coexisted with non-neuromatous second IS lesions.

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Conflict of interest

The authors declare that they have no financial conflict of interest.

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Authors and Affiliations

  1. Albert Einstein College of Medicine and Lenox Hill Radiology Imaging and Associates, Bronx, NY, USA

    Hilary Umans

  2. Albert Einstein College of Medicine, Bronx, NY, USA

    Ramya Srinivasan & Elisabeth Elsinger

  3. Lenox Hill Radiology Imaging and Associates, Bronx, NY, USA

    Gregory E. Wilde

Authors
  1. Hilary Umans
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  2. Ramya Srinivasan
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  3. Elisabeth Elsinger
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  4. Gregory E. Wilde
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Correspondence to Hilary Umans.

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Umans, H., Srinivasan, R., Elsinger, E. et al. MRI of lesser metatarsophalangeal joint plantar plate tears and associated adjacent interspace lesions. Skeletal Radiol 43, 1361–1368 (2014). https://doi.org/10.1007/s00256-014-1920-8

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  • DOI: https://doi.org/10.1007/s00256-014-1920-8

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