European Radiology

, Volume 25, Issue 4, pp 970–979 | Cite as

First metatarsophalangeal joint- MRI findings in asymptomatic volunteers

  • Tobias Johannes Dietrich
  • Flora Luciana Figueira da Silva
  • Marcelo Rodrigues de Abreu
  • Georg Klammer
  • Christian W. A. Pfirrmann



To evaluate the spectrum and frequency of MR findings of the first metatarsophalangeal joint (MTPJ) in asymptomatic volunteers.


MR imaging of 30 asymptomatic forefeet was performed with a dedicated extremity 1.5-Tesla system. Participants were between 20 and 49 years of age (mean ± SD: 35.5 ± 8.4 years). Two radiologists assessed cartilage, bone, capsuloligamentous structures, and tendons of first MTPJs on MR images.


Cartilage defects were observed in 27 % (n = 8) of first MTPJs, most frequently located at the base of the proximal phalanx (23 %, n = 7), whereas cartilage defects of the metatarsal head (13 %, n = 4) and the metatarsosesamoid compartment were rare (0 %–3 %, n = 0-1). Bone marrow oedema-like signal changes were present in 37 % (n = 11) and subchondral cysts in 20 % (n = 6) of first MTPJs. Hyperintense areas on intermediate-weighted sequences (range: 30–43 %, n = 9–13) and on fluid-sensitive sequences with fat suppression (range: 33–60 %, n = 10–18) within the medial and lateral collateral ligament complex were common. Plantar recesses (77 %, n = 23) and distal dorsal recesses (87 %, n = 26) were frequently observed.


Cartilage defects, bone marrow oedema-like signal changes, subchondral cysts, plantar recesses, and distal dorsal recesses were common findings on MRI of first MTPJs in asymptomatic volunteers. The collateral ligaments were often heterogeneous in structure and showed increased signal intensity.

Key Points

Cartilage defects of asymptomatic first metatarsophalangeal joints were common on MRI.

The collateral ligaments were often heterogeneous in structure and showed increased signal intensity.

Areas of increased signal intensity within the flexor and extensor tendons were rare.

These observations need to be considered in MR examinations of symptomatic cases.


Magnetic resonance imaging Forefoot. Metatarsophalangeal joint Asymptomatic Volunteers 



Extensor hallucis longus tendon


Echo train length


Fat suppression


Field of view


Fast spin-echo


Intraclass correlation coefficient




Metatarsophalangeal jointl


Number of signals acquired


Standard deviation


Short-Tau inversion recovery




Echo time


Inversion time


Repetition time



The scientific guarantor of this publication is Tobias J. Dietrich, MD, Radiology, Orthopedic University Hospital Balgrist, University of Zurich, Forchstrasse 340, CH-8008 Zurich, Switzerland. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (volunteers) in this study. No study subjects and no cohorts have been reported or published previously. Methodology: prospective, observational, performed at one institution.

Conflict of interest

No conflict of interest declared.


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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • Tobias Johannes Dietrich
    • 1
  • Flora Luciana Figueira da Silva
    • 1
    • 2
  • Marcelo Rodrigues de Abreu
    • 2
  • Georg Klammer
    • 3
  • Christian W. A. Pfirrmann
    • 1
  1. 1.Radiology, Orthopedic University Hospital BalgristUniversity of ZurichZurichSwitzerland
  2. 2.Radiology, Hospital Mãe de Deus and Mãe de Deus CenterPorto AlegreBrazil
  3. 3.Orthopedic Surgery, Orthopedic University Hospital BalgristUniversity of ZurichZurichSwitzerland

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