,…. or WTF is metatarsalgia and shouldn’t a top rated hospital in NYC, specifically for treating orthopedic, foot and ankle, etc., be able to help this patient?

https://www.podiatrytoday.com/blogged/why-metatarsalgia-may-not-be-what-it-seems

https://wp.me/PatDXe-G

https://2ndmtpjoint.home.blog/patient-recent-history-post-trauma/

Continue reading “MR Arthrography of the Second and Third Metatarsophalangeal Joints for the Detection of Tears of the Plantar Plate and Joint Capsule,…. question” →

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.

I have trauma to ball of foot and have been diagnosed with second MTP joint synovitis/capsulitis inflammation after stepping on a rock at Ditch Plains Beach on July 1st, 2018. 

DIAGNOSTIC ULTRASOUND EXAMINATION OF THE LEFT FOOT (image above)

HISTORY: Left 2nd toe pain. Patient reports prior plantar plate repair.

COMPARISON: Left forefoot MRI, 07/10/2018. Left foot radiographs, 09/19/2018.

TECHNIQUE: 2-D grayscale and Doppler ultrasound images of the left foot were obtained in the regions of interest delineated by the referring clinician.

IMPRESSION for Ultrasound

There is mineralization within the 2nd MTP plantar plate towards the phalangeal attachment, but no evidence of acute or high-grade tear. Mineralization may be secondary to prior trauma or surgery. There is mild 2nd MTP arthrosis, producing tiny osteophytes and mild joint synovial thickening.

The 1st and 3rd MTP plantar plates are not torn, although mineralization is noted at the 3rd MTP plantar plate. There is no intermetatarsal bursitis.

Has anyone had this or something similar to it? Are you going through this now? What treatements have you used? How long did it take to heal? Any information would be helpful. Thanks so much!