MR Arthrography of the Second and Third Metatarsophalangeal Joints for the Detection of Tears of the Plantar Plate and Joint Capsule

Kier, Ruben; Abrahamian, Haroutun; Caminear, David S.; Eterno, Robert; Feldman, Alan S.; Abrahamsen, Thomas; Davis, Daniel E.; Rice, Andrew

doi:10.2214/ajr.09.3393

Cited by 28 publications

(26 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…MR arthrography confirmed deficiencies in 10 plantar plates, extravasation of contrast agent was seen in the surrounding soft tissue of 6, confirming a tear in the capsule, and extravasation of contrast agent was seen in the flexor tendon of only 4, confirming a true plantar plate tear 11 . Two plantar plates showed no extravasation of contrast agent on arthrography (contrast agent was not successfully injected into 1 joint); both demonstrated high signal at the insertion on standard MR.…”

Section: Rheumatologymentioning

confidence: 82%

“…Previous studies in cadaveric specimens and subjects without RA have compared standard MR imaging with MR arthrography in diagnosing soft tissue pathology at the lesser MTP joints 6,10,11 . These studies have suggested that MR arthrography improves visualization of the structures and delineates capsule tears from plantar plate tears.…”

Section: Discussionmentioning

confidence: 99%

“…Controversy about the appearance of the distal insertion has been highlighted, in which a hyperintense region has been interpreted as evidence for a tear 6 . Conversely, MR arthrography of MTP joints in cadavers and in subjects without RA has demonstrated improved visualization and delineation of tears in the fibrous capsule and plantar plate 10,11,12 , but the technique has not been applied in patients with RA.…”

Section: Rheumatologymentioning

confidence: 99%

“…Subsequently, contrast agent extravasation was assessed on the arthrographic images. MR arthrographic abnormalities at the lesser MTP joints were ordered into 4 grades: (1) no pathology ( Figure 1A, 1B); (2) extravasation of contrast agent into the adjacent soft tissues (interpreted as a capsule tear 8,11 ; Figure 1C, 1D); (3) extravasation of contrast agent into the flexor digitorum longus tendon sheath (interpreted as a plantar plate tear 6,11 ); and (4) extravasation of contrast agent into both the surrounding soft tissues and the flexor tendon sheath (Figure 2). …”

Section: Recruitment Of Patientsmentioning

confidence: 99%

See 3 more Smart Citations

Magnetic Resonance Arthrography of Lesser Metatarsophalangeal Joints in Patients with Rheumatoid Arthritis: Relationship to Clinical, Biomechanical, and Radiographic Variables

Siddle

Hodgson

O’Connor³

et al. 2012

J Rheumatol

View full text Add to dashboard Cite

Objective.Our exploratory study of painful lesser metatarsophalangeal (MTP) joints in patients with rheumatoid arthritis (RA) primarily aimed to compare the clinical, biomechanical, and plain radiography findings with magnetic resonance (MR) arthrography findings. Our secondary aim was to compare standard unenhanced MR with MR arthrography in imaging the lesser MTP joints in RA.Methods.In 15 patients with RA, the more symptomatic forefoot was imaged using 3T MR imaging. Proton density fat-suppressed images were acquired through the lesser MTP joints prior to arthrography. Under ultrasound guidance, contrast agent was injected into 2 lesser MTP joints. T1-weighted fat-suppressed sequences were subsequently acquired. The MR images were read by 2 musculoskeletal radiologists and consensus was reached. Spearman’s correlation coefficient was used to assess the association between abnormalities seen on MR arthrography and the clinical, biomechanical, and plain radiography findings.Results.MR arthrography demonstrated pathology at 18 of 28 lesser MTP joints (64%) examined in patients with RA. MR arthrography abnormalities were associated with RA disease duration, forefoot deformity, Larsen score, subluxation, and peak plantar pressure. Unenhanced MR had a sensitivity of 78% and specificity of 90% for detecting pathology compared to MR arthrography.Conclusion.Capsule and plantar plate pathology occurs in the painful forefoot of patients with RA and is associated with features of disease and deformity at the lesser MTP joints. Compared with MR arthrography, standard MR imaging was highly specific and moderately sensitive for diagnosing lesser MTP joint pathology in patients with RA.

show abstract

Section: Rheumatologymentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Rheumatologymentioning

confidence: 99%

Section: Recruitment Of Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Magnetic Resonance Arthrography of Lesser Metatarsophalangeal Joints in Patients with Rheumatoid Arthritis: Relationship to Clinical, Biomechanical, and Radiographic Variables

Siddle

Hodgson

O’Connor³

et al. 2012

J Rheumatol

View full text Add to dashboard Cite

show abstract

“…Zur Darstellung von Verletzungen der plantaren Platte wurden Ultraschall, konventionelle Arthrographie, MRT und MR-Arthrographie eingesetzt, wobei der Ultraschall unter Dorsalflexion der betroffenen Zehe als aussagekräftiges und gleichzeitig einfaches Verfahren angesehen wird [2,8,9].…”

Section: Cmeunclassified

Akute Sportverletzungen und chronische Überlastungsschäden an Vor- und Mittelfuß

Wörtler

Schäffeler

2015

Radiologe

View full text Add to dashboard Cite

Sports injuries of the foot can occur as sequelae of acute trauma or chronic overuse. Besides clinical examination, imaging plays a major role in the detection of structural abnormalities and the differential diagnostics. This article reviews the most important sports-related soft tissue and bone pathologies of the forefoot and midfoot together with their typical findings on radiography, ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI).

show abstract

2nd Metatarsophalangeal Joint Pathology: Pre-dislocation Syndrome

Klein

WeilJr

2020

Evidence-Based Podiatry

View full text Add to dashboard Cite

MR Arthrography of the Second and Third Metatarsophalangeal Joints for the Detection of Tears of the Plantar Plate and Joint Capsule

Cited by 28 publications

References 8 publications

Magnetic Resonance Arthrography of Lesser Metatarsophalangeal Joints in Patients with Rheumatoid Arthritis: Relationship to Clinical, Biomechanical, and Radiographic Variables

Magnetic Resonance Arthrography of Lesser Metatarsophalangeal Joints in Patients with Rheumatoid Arthritis: Relationship to Clinical, Biomechanical, and Radiographic Variables

Akute Sportverletzungen und chronische Überlastungsschäden an Vor- und Mittelfuß

2nd Metatarsophalangeal Joint Pathology: Pre-dislocation Syndrome

Contact Info

Product

Resources

About