Symptomatic Bipartite Medial Cuneiform Treated with Fluoroscopic and Ultrasound-Guided Injections

Bipartite Medial Cuneiform and Calcaneo-Navicular Coalition in a Single Individual

“…leads to failure of the two separate portions merging, thus leaving a cartilaginous or fibrocartilagenous synchrondrosis between the two segments [1][2][4][5][8][9][10]. Cases of partial and complete bipartition have been described [1].…”

“…During early embryonic development the medial cuneiform forms either from a single or two separate portions of a single cartilaginous anlage [1,[4][5][6][7]. Bipartition occurs when abnormal organisation of the primordial mesenchyme and progressing medially until complete ossification occurs around the age of 3 [4][5]8].…”

“…Bipartition occurs when abnormal organisation of the primordial mesenchyme and progressing medially until complete ossification occurs around the age of 3 [4][5]8]. During this time the bipartite deformity may become apparent on imaging with a characteristic 'E-Sign' [4][5][6], which can be seen on both sagittal MRI and CT scans as demonstrated in Figure 2.…”

“…Bipartition occurs when abnormal organisation of the primordial mesenchyme and progressing medially until complete ossification occurs around the age of 3 [4][5]8]. During this time the bipartite deformity may become apparent on imaging with a characteristic 'E-Sign' [4][5][6], which can be seen on both sagittal MRI and CT scans as demonstrated in Figure 2. The volume of a bipartite medial cuneiform is recognised as being slightly larger than that of a normal medial cuneiform with an increased dorso-plantar height of between 5-8mm [1,5,[11][12].…”

“…During this time the bipartite deformity may become apparent on imaging with a characteristic 'E-Sign' [4][5][6], which can be seen on both sagittal MRI and CT scans as demonstrated in Figure 2. The volume of a bipartite medial cuneiform is recognised as being slightly larger than that of a normal medial cuneiform with an increased dorso-plantar height of between 5-8mm [1,5,[11][12]. Variations in the articular surfaces include a split facet for articulation of the plantar and dorsal segments with the first metatarsal, as well as that for the navicular [11][12].…”