Lisfranc Joint Ligamentous Complex: MRI With Anatomic Correlation in Cadavers

Castro, Miguel; Melão, Lina; Canella, Clarissa; Weber, Marcio; Negrão, Pedro; Trudell, Debra; Resnick, D

doi:10.2214/ajr.10.4674

Cited by 94 publications

(84 citation statements)

References 16 publications

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“…In addition, there is debate as to whether radiography should be the initial imaging modality in the setting of a suspected Lisfranc injury, as patients with Lisfranc sprains may incur ligamentous damage without diastasis [26]. CT and MRI have been advocated as the best imaging tests (especially if the patient is not able to bear weight), and 3D-volumetric acquisitions have proven superiority, compared with orthogonal proton-density fat-suppressed imaging [17,18,[27][28][29][30][31].…”

Section: Discussion Of Imaging Modalities By Variantmentioning

confidence: 99%

ACR Appropriateness Criteria Acute Trauma to the Foot

Bancroft¹,

Kransdorf

Adler³

et al. 2015

Journal of the American College of Radiology

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This ACR Appropriateness Criteria article offers imaging triage guidance for several variants of patients presenting with acute foot trauma. Patients meeting inclusion criteria for the Ottawa Rules should undergo a 3-view radiographic series. Diabetic patients with peripheral neuropathy should undergo radiography, even though they do not meet the Ottawa Rules inclusion criteria. Patients with suspected midfoot and/or Lisfranc injury should undergo 3-view radiographs with weight bearing on at least the anterior-posterior view. Patients with suspected Lisfranc injury and normal radiographs should be considered for MRI and CT on a case-by-case basis. MRI or ultrasound could confirm cases of suspected acute tendon rupture. Radiography is the initial imaging modality for suspected plantar plate injury after metatarsal-phalangeal joint injury. Weight-bearing anterior-posterior, lateral, and sesamoid axial views may detect proximal migration of the hallux sesamoids. Ultrasound or MRI can directly evaluate the capsuloligamentous complex, specifically the plantar plate. Radiography can detect radiopaque penetrating foreign bodies, and ultrasound can be helpful in detecting those that are nonradiopaque. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures, by the panel. In instances in which evidence is lacking or is not definitive, expert opinion may be used to recommend imaging and treatment.

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Section: Discussion Of Imaging Modalities By Variantmentioning

confidence: 99%

ACR Appropriateness Criteria Acute Trauma to the Foot

Bancroft¹,

Kransdorf

Adler³

et al. 2015

Journal of the American College of Radiology

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“…Furthermore, with MR imaging, an asymptomatic bipartite medial cuneiform should not have been associated with bone marrow edema. Due to the well-defined joint space between the base of the first metatarsal and the distal portion of the medial bipartite cuneiform as well as between the two bipartite portions, a “E” joint space configuration is demonstrated on MR imaging in the sagittal plane, the so-called E-sign [3, 12]. …”

Section: Discussionmentioning

confidence: 99%

Bipartite Medial Cuneiform: Case Report and Retrospective Review of 1000 Magnetic Resonance (MR) Imaging Studies

Chang

Chung

et al. 2014

Case Reports in Medicine

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Objective. To present a unique case report of a Lisfranc fracture in a patient with a bipartite medial cuneiform and to evaluate the prevalence of the bipartite medial cuneiform in a retrospective review of 1000 magnetic resonance (MR) imaging studies of the foot. Materials and Methods. Case report followed by a retrospective review of 1000 MR imaging studies of the foot for the presence or absence of a bipartite medial cuneiform. Results. The incidence of the bipartite medial cuneiform is 0.1%. Conclusion. A bipartite medial cuneiform is a rare finding but one with both clinical and surgical implications.

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“…Instead, the Lisfranc ligament complex, which is composed of dorsal, interosseous, and plantar components, courses obliquely between the medial cuneiform and second and third metatarsal bases [7-10]. Because it is considered the thickest, strongest, and best visualized component on MR images, the interosseous component is referred to as the Lisfranc ligament proper [5,7,10].The most common mechanism of Lisfranc injury is an axial load through the joint while the foot is in rigid plantar flexion. This force drives the metatarsals dorsally and produces ligamentous disruption and fractures along the tarsometatarsal joints.…”

mentioning

confidence: 99%

“…In addition, strong, bandlike transverse intermetatarsal ligaments are present between the second through fifth metatarsals; however, no ligament is present between the proximal aspects of the first and second metatarsals [3,[5][6][7]. Instead, the Lisfranc ligament complex, which is composed of dorsal, interosseous, and plantar components, courses obliquely between the medial cuneiform and second and third metatarsal bases [7][8][9][10].…”

mentioning

confidence: 99%