OCAD MSK

History

64F 7months pain at 2nd MTP joint, rule out neuroma

Figure 1 for case plantar plate of metatarsophalangeal joint ( RID3134 ) — Figure 1

Figure 2 for case plantar plate of metatarsophalangeal joint ( RID3134 ) — Figure 2

Figure 3 for case plantar plate of metatarsophalangeal joint ( RID3134 ) — Figure 3

Figure 4 for case plantar plate of metatarsophalangeal joint ( RID3134 ) — Figure 4

Discussion

On inspection she had mild hyperextension and tibial deviation of her 2nd toe. She first noticed that 6-7 months ago. She has focal tenderness under the 2nd MT head. 1-2+ instability on MTP joint vertical stress test. None of this suggests neuroma. Images 1-2 show the flexor tendon immediately supeficial to the 2nd MT head with NO intervening plantar plate. The plantar plate is torn and retracted. The 2nd (short axis) image shows the same, with lateral eccentric pericapsular hypoechoic scarring (pseudoneuroma). Normal comparison Long and Short axis images in the 3rd and 4th images; flexor tendon (yellow arrow), plantar plate (red arrow).

Diagnosis

plantar plate of metatarsophalangeal joint ( RID3134 )

Hilary Umans, MD

Courtesy

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