Is Second Metatarsal Protrusion Related to Metatarsophalangeal Plantar Plate Rupture?

Mann, Tânia Szejnfeld; Nery, Caio; Baumfeld, Daniel; Fernandes, Eloy A.

doi:10.2214/ajr.19.22563

Cited by 13 publications

(13 citation statements)

References 29 publications

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“…As such, the relative length of the second metatarsal protrusion should be measured on imaging. 20 In a recent study, a second metatarsal protrusion length cut-off values of 5.47 mm on radiographs correlated with an MTP PP tear (area under the curve: 0.633, sensitivity: 35.8%, specificity: 88.6%). 20…”

Section: Role Of Imagingmentioning

confidence: 92%

“…3 ). 20 In the midsagittal plane of approximately half of normal lesser MTP joint MRI studies, there is a high SI zone at the PP insertion on the proximal phalanx. This high SI zone is an anatomical recess adjacent to the proximal phalangeal articular cartilage.…”

Section: Normal Plantar Platementioning

confidence: 97%

“…2 7 In a fashion similar to plain films, second metatarsal protrusion length with a cut-off value of 3.17mm on MRI correlates with MTP PP injury. 20…”

Section: Indirect Signs Of Pp Injuries Pericapsular Thickening Pseudo...mentioning

confidence: 99%

“…In our experience and in the more recent literature, MN in the second interdigital space are uncommon, if not rare, and were overcalled in the older literature. 5 20…”

Section: Indirect Signs Of Pp Injuries Pericapsular Thickening Pseudo...mentioning

confidence: 99%

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Differential Diagnosis of Metatarsalgia

Afonso,

Britto,

Spritzer

et al. 2023

Semin Musculoskelet Radiol

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Lesser (or central) metatarsalgia is defined as pain in the forefoot under or around the lesser metatarsals and their respective metatarsophalangeal joints. Two common causes of central metatarsalgia are Morton's neuroma (MN) and plantar plate (PP) injury. Because both clinical and imaging features overlap, establishing the correct differential diagnosis may be challenging. Imaging has a pivotal role in the detection and characterization of metatarsalgia. Different radiologic modalities are available to assess the common causes of forefoot pain, so the strengths and weakness of these imaging tools should be kept in mind. It is crucial to be aware of the pitfalls that can be encountered in daily clinical practice when dealing with these disorders. This review describes two main causes of lesser metatarsalgia, MN and PP injury, and their differential diagnoses.

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Section: Role Of Imagingmentioning

confidence: 92%

Section: Normal Plantar Platementioning

confidence: 97%

“…2 7 In a fashion similar to plain films, second metatarsal protrusion length with a cut-off value of 3.17mm on MRI correlates with MTP PP injury. 20…”

Section: Indirect Signs Of Pp Injuries Pericapsular Thickening Pseudo...mentioning

confidence: 99%

“…In our experience and in the more recent literature, MN in the second interdigital space are uncommon, if not rare, and were overcalled in the older literature. 5 20…”

Section: Indirect Signs Of Pp Injuries Pericapsular Thickening Pseudo...mentioning

confidence: 99%

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Differential Diagnosis of Metatarsalgia

Afonso,

Britto,

Spritzer

et al. 2023

Semin Musculoskelet Radiol

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“…44,[57][58][59][60] Predisposing factors for chronic overload of the second MTP joint and subsequent plantar plate tear include the presence of a long second metatarsal and hypermobility of the first ray, hallux valgus, and pes planus. 43,61 Wearing high-heeled shoes and shoes with a narrow toe box may cause chronic hyperextension at the MTP joint, leading to elongation of the plantar aponeurosis and capsular constraints. 48,49 Less commonly, acute traumatic tears of the plantar plate of lesser MTP joints may occur in young adult athletes in the absence of underlying plantar plate degeneration.…”

Section: Biomechanics Pathogenesis and Clinical Findingsmentioning

confidence: 99%

Presurgical Perspective and Postsurgical Evaluation of Plantar Plate and Turf Toe

Dimmick¹,

Reeve²,

Linklater³

2022

Semin Musculoskelet Radiol

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Capsuloligamentous injury of the first metatarsophalangeal (MTP) joint (eponymously called “turf toe”) mostly occurs in athletes and involves acute trauma, whereas tears of the lesser MTP joint plantar plate typically are an attritional-degenerative condition. This article reviews the anatomy, pathophysiology, mechanism and patterns of injury, grading and classification of injury, imaging appearances (pre- and postoperative), and management of first MTP joint capsuloligamentous injuries and lesser MTP joint plantar plate tears. These two distinct pathologies are discussed in separate sections.

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