MRI

EXAM: MRI FOREFOOT LEFT WO CONTRAST

TECHNIQUE:
1. Coronal inversion recovery sequence
2. Coronal, axial and sagittal proton density sequences
COMPARISON:
1. Radiographs of the left foot 07/03/2018
2. MRI of the left forefoot 08/05/2010
INDICATION: 57-year-old female with left medial foot pain with clinical concern for medial sesamoid fracture.
Relevant surgical history: Left forefoot surgery 2009

FINDINGS:

There is no occult fracture, specifically no sesamoid fracture. There appears to be mild chondral wear over the 1st metatarsal head, more notably affecting the metatarsal sesamoid articulations. A small synovial effusion/synovitis is present. There is bony remodeling of the lateral sesamoid. The
hallux sesamoid phalangeal ligaments are not disrupted, though there is mild scar remodeling laterally.

Healed shortening osteotomy of the 2nd metatarsal is redemonstrated. The 2nd MP joint shows mild osteoarthritis without bulky synovitis. The plantar plate is remodeled but not detached. The cartilage over the MP joints of the lesser metatarsals appears maintained and there is no bulky synovitis.
Plantar plates appear intact.

Scar infiltration at the 2nd webspace is re-identified.

Regional flexor and extensor tendons are maintained. Imaged portion of the Lisfranc ligamentous complex is intact.

IMPRESSION

Since the MRI of the left forefoot from 08/05/2010, there has been interval bony remodeling of the lateral hallux sesamoid and there is no sesamoid fracture or osteonecrosis. There is mild 1st MP osteoarthritis and mild synovitis, probably mildly progressive.

Healed 2nd metatarsal shortening osteotomy with mild 2nd MP arthrosis is essentially unchanged.