MRI of injuries to the first interosseous cuneometatarsal (Lisfranc) ligament

Abstract

MRI is reasonably accurate at detecting traumatic injury to the Lisfranc ligament. However, in clinically suspected cases of traumatic Lisfranc ligament injury, true positive rate for sprain is low.

Vector correlation technique for pixel-wise detection of collagen fiber realignment during injurious tensile loading

“…However, conventional imaging techniques, such as computed tomography or magnetic resonance imaging, often cannot identify less severe tissue damage that can be sustained during ligament sprains and other painful injuries. [5][6][7] Historically, biomechanical studies of tissue injury have been primarily focused on defining ligament tolerances at mechanical failure, where tissue rupture is unmistakably detectable by visual inspection. [7][8][9] Although these traditional methods of defining tissue tolerance and identifying the location of injury have provided valuable advances in injury prevention, detecting the initiation of mechanical damage during soft tissue loading, and localizing it spatially, is necessary to begin to develop both physiologically relevant injury tolerances and an anatomical understanding of the mechanical manifestations of tissue damage.…”

ACR Appropriateness Criteria Acute Trauma to the Foot

“…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].…”

“…The 2 modalities have a similar sensitivity for acute soft-tissue trauma about the ankle and foot, such as ligamentous and tendinous disruption [15][16][17][18]. The choice of modality is usually determined by costs, availability of technology, and availability of expert musculoskeletal sonographers and interpreters.…”

Tip-of-the-Iceberg Fractures: Small Fractures That Mean Big Trouble

“…2). Fluid-sensitive T2-weighted sequences are excellent for depicting ligament tears and associated findings, such as muscle tears, capsular disruption, bone marrow contusions and fractures, and fluid tracking along the first metatarsal shaft [1,3,7,13] (Fig. 3).…”