The step-off sign is the radiographic appearance of Lisfranc injury on lateral projections of the foot when there is a dorsal displacement of the second metatarsal base. However, in mild cases, a Lisfranc injury can be missed on X-ray. Skeletal radiology 49.1 (2020): 31-53. Lisfranc Fracture Dislocation. All highlighted initial/choice studies from the powerpoints Learn with flashcards, games, and more — for free. Prediction of midfoot instability in the subtle Lisfranc injury: Comparison of magnetic resonance imaging with intraoperative findings. A study of 15 patients with subtle Lisfranc injuries reported normal-appearing findings on initial non–weight- bearing radiographs in 50% of patients, with low-impact injuries influences their clinical and A Lisfranc fracture is a type of broken foot. Most MRI studies assessed Lisfranc ligament integrity. The isolated kind involves only one or two metatarsals being displaced from the other three long bones. Lisfranc Injury in the Athlete JBJS Rev. The imaging features of injury at the Lisfranc joint are reviewed, and guidance is provided as to the appropriate use and interpretation of weight bearing radiographs, computed tomography, and magnetic resonance imaging. very useful in the initial evaluation of most conditions affecting the forefoot and midfoot. 141 This document was downloaded for personal use only. ↑ Sripanich, Yantarat, et al. Injuries to the tarsometatarsal joint can be caused by low or high impact. The coronal plane is slightly oblique, perpendicular to C1. Thirty articles were subdivided by imaging modality: conventional radiography (17 articles), ultrasonography (si Its integrit… Tendons and ligamentous structures are better imaged using MRI. Magnetic resonance imaging (MRI) is a sensitive and specific imaging modality and should be considered in injuries with equivocal physical and radiographic findings. If you have suffered a Lisfranc fracture, your doctor may need to perform surgery to help stabilize your foot. Sometimes surgery is not necessary. A period of immobilization is usually required after a Lisfranc injury whether surgery was performed or not. of midfoot instability in the subtle Lisfranc injury. The radiographic signs of Lisfranc injuries can be subtle, and it is important to understand the patterns of these injuries to aid in diagnosis and help clinicians asse… Crues is the Medical Director of RadNet Management, and a Volunteer Clinical Professor of Medicine, University of California-San Diego School of Medicine, San Diego, CA.. appearances of Lisfranc injuries of the foot. Only one of these defined the Lisfranc and the plantar ligaments as separate structures [ 14 ]. Stable Fracture s or dislocations may be splinted and followed up in orthopedics in 1-2 weeks. (Right) The tear of the Lisfranc ligament is more evident in this weightbearing stress x-ray, showing a widening of the joint. In the athlete, there is a reduced threshold for imaging to clarify diagnosis, guide prognosis, and treatment. Although Lisfranc joint complex injuries are relatively uncommon, misdiagnosis or undertreatment of these injuries can lead to significant patient morbidities, such as midfoot pain, planovalgus deformity, and osteoarthritis. Seminars in Musculoskeletal Radiology Vol. 2/2016 Lisfranc Injury Imaging and Surgical Management Llopis et al. MR imaging has been shown to demonstrate the Lisfranc ligament complex reliably in the normal foot.17 Materials and Methods Institutional Review Board approval was obtained, and informed consent was waived. Thumb 2000- 50-70 8 16 6000 256 x 192 3/0.3 2 Axial 10 T2 FSE Fat Sat 256 x 192 3/0.3 400-800 minimal 1 Axial 10 T1 SE 3.0T: 180 8 16 1.5T: 150 0.7T 100 It presents a sensitivity and predictive value of up to 94% in determining instability of the Lisfranc joint and can therefore be useful for the diagnosis of the subtle Lisfranc injury. The axial plane follows the long axis of the metatarsals. These studies can create better images of soft tissues like the tendons. An acute injury of the ligament may present with sudden onset of pain at the medial aspect of the mid-foot, whereas chronic repetitive injuries of the Lisfranc ligament may only lead to vague discomfort or tenderness and therefore may not be clinically suspected 13. In one study, nearly 25% of Lisfranc injuries were missed or appeared normal on initial radiographs because of subtle diastasis (12). These studies can create better images of soft tissues like the tendons. An important concept in interpreting an MRI of suspected Lisfranc ligament injury is that a ligament with a mechanically significant injury may still appear intact on MRI. The Lisfranc injury is a popular topic in the radiology, orthopedic surgery, and emergency medicine literature, primarily due to the subtleties of the radiographic findings and potentially dire consequences of missed diagnoses. First, small avulsions can be very hard to detect on MRI; second, the ligament may be stretched and insufficient without appearing discontinuous. Lisfranc Fracture Dislocation. : To evaluate the applicability of an MRI-compatible foot stressor device in patients with image-proven or clinically suspected Lisfranc joint injuries. 2009 Apr;91(4):892-9 • Coss HS, Manos RE, Buoncristiani A, Mills WJ. CT clarifies tarsometatarsal (TMT) joint alignment and occult fractures obscured on radiographs. The Lisfranc ligament is a strong band attaching the medial cuneiform to the 2nd metatarsal base on the foot's plantar aspect. At the medical examination, the orthopaedic specialist surgeon will look for signs of bruising, swelling, and then feel for areas of swelling. The collateral ligaments are typically a thin, linear, low-signal intensity structure. Prediction of midfoot instability in the subtle Lisfranc injury: Comparison of magnetic resonance imaging with intraoperative findings. The Lisfranc joint complex is a complicated skeletal and capsuloligamentous structure that provides stability to the midfoot and forefoot. Lisfranc Fracture. Lisfranc injury radiology In severe cases of a mid-foot injury, a plain X-ray is all that is required to pick up a bad fracture or dislocation. In addition, MRI could further evaluate the injury degree of Lisfranc ligament. How are Lisfranc injuries diagnosed? (Redrawn with permission from Solan MC, Moorman CT III, Miyamoto RG, Jasper LE, Belkoff MR Imaging of the MidfootIncluding Chopart and Lisfranc Joint Complexes. 1. ... MRI Online is a premium online continuing education resource for practicing radiologists to expand their radiology expertise across all modalities, read a wide variety of cases, and become a more accurate, confident, and efficient reader. 141 This document was downloaded for personal use only. It presents a sensitivity and predictive value of up to 94% in determining instability of the Lisfranc joint and can therefore be useful for the diagnosis of the subtle Lisfranc injury. A Lisfranc injury can occur when something heavy falls on the foot, or when a car runs over it, or when someone lands on his or her foot after falling from a great height. It can also happen when someone falls from a horse while one foot remains trapped in the stirrup, as happened to many of the soldiers observed by Dr. Lisfranc himself. For ultrasonography, C1-M2 distance and dorsal Lisfranc ligament (DLL) length and thickness are evaluated. Since 2001, Radsource has earned a reputation as one of the most trusted names in medical imaging. A Lisfranc injury is often mistaken for a simple sprain, especially if the injury is a result of a straightforward twist and fall. However, injury to the Lisfranc joint is not a simple sprain that should be simply "walked off.". It is a severe injury that may take many months to heal and may require surgery to treat. The metatarsals then proceed to the point where your toes are located, while the tarsals reside at the arch that is atop your foot. The ankle and foot are commonly injured during sporting activities. MRI imaging can also be useful to determine the amount of damage to ligaments, soft tissue, and joints that are not visible on X-ray. Magnetic resonance imaging of the Lisfranc ligament On the MRI images, the sagittal section can clearly display the corresponding situation of the Lisfranc joint bone and longitudinal arch of the foot, tolerably display the Lisfranc joint dorsal ligaments and metatarsal ligaments, and poorly display the Lisfranc ligament. For purposes of MR imaging, the foot is divided into two exams: 1. MR Imaging of the Diabetic Foot. Castro M, Melao L, Canella C, et al. Named after Jacques Lisfranc, a field surgeon in Napoleon’s army, who described a new technique for an amputation used to treat frostbite of the forefoot in soldiers on the Russian front ... are dislocated laterally in this homolateral Lisfranc dislocation. 9 , 10 Implanted surgical hardware, including joint prostheses, may produce sufficient local artifact to preclude adequate imaging through the region containing hardware. MRI imaging can confirm the presence of purely ligamentous injury. J Bone Joint Surg Am 2009;91:892-899.) Hence, there is no available auxiliary examination for diagnosing related injuries. Incorporating a specific MRI protocol when there is a suspicion of a subtle Lisfranc injury can help radiologists with the diagnosis of this kind of pathology and also can have a positive impact on a better diagnosis and prognosis for affected patients. Magnetic resonance imaging … MRI Interpretation + ProtonPACS. The authors studied 23 patients (mean age, 25.4 years) with a history of midfoot trauma with both radiographs and magnetic resonance imaging (MRI). Lisfranc injuries are sometimes mistaken for ankle sprains, making the diagnostic process very important. •Must have high index of suspicion. Management of complex open fracture injuries of the midfoot with external fixation. MagnReson Imaging Clin N Am. It may be ordered in cases where the diagnosis may be in doubt. Raikin et al showed that MRI is accurate for detecting traumatic injury of the Lisfranc ligament and for predicting Lisfranc joint complex instability when the plantar Lisfranc ligament bundle is used as a predictor. This injury most commonly occurs via high-impact trauma (such as a car accident or fall) or sports-related situations. Subsequently progressive Charcot neuro-osteoarthropathy is seen with dislocation of the Lisfranc joint. Use of contrast is at the discretion of both the ordering and imaging physicians. MRI Online. A Lisfranc dislocation or injury typically describes a spectrum of injuries involving the tarsometatarsal joints of the foot. Like all fractures, the treatments you’ll need and your recovery time will depend on the severity of your original injury. The first three metatarsals articulate with the three cuneiforms, respectively, and the 4 th and 5 th metatarsals with the cuboid. Ankle/Hindfoot/Midfoot (everything behind metatarsals) 2. A Lisfranc injury is a tarsometatarsal fracture dislocation characterized by traumatic disruption between the articulation of the medial cuneiform and base of the second metatarsal. Weight-bearing X-rays are standard for determining if a Lisfranc injury exists. At present, few studies on the imaging of Lisfranc ligaments have been reported, and related imaging data are rare. Reduce significant acute, closed dorsal dislocations in the emergency department. ¤ Arnold G, et al. Method : This prospective study evaluated Lisfranc joint injury by utilizing a joint-specific, stress device that was engineered to replicate weightbearing and physical examination maneuvers. Named after Jacques Lisfranc, a field surgeon in Napoleon’s army, who described a new technique for an amputation used to treat frostbite of the forefoot in soldiers on the Russian front ... are dislocated laterally in this homolateral Lisfranc dislocation. Early recognition of subtle Lisfranc injuries is important, because deformity and disability may develop after initially unremarkable radiographs. The tarsometatarsal joint, or Lisfranc joint, is the articulation between the tarsus () and the metatarsal bases (), representing a combination of tarsometatarsal joints.. Figure 1 Anatomic location of the dorsal, Lisfranc, and plantar ligaments. The midfoot joint complex is located at the point in which your metatarsal bones intersect with your tarsal bones. Normal Magnetic Resonance Imaging Anatomy of the Ankle & Foot. Splint patients if any suspicion of Lisfranc Injury. Several imaging studies have been published that define the role of MRI in the diagnosis of ligamentous injury of the foot and ankle [ 1, 6, 10 – 15 ]. In this article, we discuss Chopart joint anatomy, pathomechanisms of midtarsal sprains, clinical implications, and radiographic and cross-sectional imaging findings, with a focus on MRI. The Lisfranc foot injury is split into three classifications. Primary synovial chondromatosis is rare in the foot. magnetic resonance imaging (MRI). Foot Injuries / diagnostic imaging* Disruption of the so-called Lisfranc ligament on MRI is highly suggestive of an unstable midfoot injury [3]. To arrive at a diagnosis, the foot and ankle surgeon will ask questions about how the injury occurred and will examine the foot to determine the severity of the injury. Lisfranc injury •Jacques Lisfrancde St. Martin 4/2/1790 -5/13/1847 French surgeon and gynecologist ¤ McCarthy E, Morrison WB, Zoga AC. Management Abduction stress and AP weightbearing radiography of purely ligamentous injury in the tarsometatarsal joint. Man with interosseous Lisfranc ligament injury, with spectrum of imaging findings seen on long-axis fat-suppressed proton-density MRI sequencing. Computerized tomography scan (CT ) scan. 2017 Sep;5(9):e4. MSK MRI PROTOCOLS. Lisfranc injury may range from isolated ligamentous sprain to complete disruption of the tarsometatarsal articulation. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Lisfranc Ligament Injury 10-year-old female - Classifying Lisfranc injury on MRI. doi: 10.2106/JBJS.RVW.17.00025. Chandran P, Puttaswamaiah R, Dhillon MS, et al. The Lisfranc joint has complex structures, and articular surfaces overlap on conventional X-ray radiographs. (M2), is known as the Lisfranc ligament, and is vital to the support of the tarsometatarsal joint. We report a case of synovial chondromatosis affecting multiple sites of the foot and causing bone erosions in a 44-year-old woman. 5 MRI scan planning off the sagittal plane image. Methods MRI scanning was performed on 60 sides of normal feet of 30 healthy adult volunteers. In an article published in the August 2006 issue of this journal, the authors reviewed magnetic … This midfoot injury was first described by Dr. Jacques Lisfranc, a gynecological surgeon, who was part of Napoleon’s army. Imaging of Lisfranc injuries in the athlete. Radiographs demonstrated erosions of multiple metatarsals including the tarsometatarsal joints, resulting in Lisfranc tarsometatarsal dislocation. This study provides a certain imaging reference for the MRI scanning, diagnosis, and repair of Lisfranc joint injuries. Magnetic resonance imaging (MRI) may be beneficial in the instance of a subtle Lisfranc injury, particularly if a patient is unable to tolerate weightbearing radiographs. A repeat x-ray (Figure 1, B and C), this time weightbearing with comparison views clearlyshowed diastasis of the Lisfranc ligament. bilateral weight-bearing anteroposterior radiographic imaging with 30° oblique, and lateral views of the involved foot and ankle.1,4 To systematically review current diagnostic imaging options for assessment of the Lisfranc joint. Magnetic resonance imaging (MRI) can be useful in assessing the Lisfranc ligament. Lisfranc Injury in the Athlete. Thin-cut CT imaging often identifies small fractures and subtle subluxation of the joint. 1,4,15 Abducted stress radiographs of the affected foot may be useful to demonstrate dynamic instability of the Lisfranc joint complex. In some patients, it is necessary to proceed to more sophisticated scanning techniques including computed tomography or magnetic resonance imaging. PubMed and ScienceDirect were systematically searched. Subtalar dislocations and Lisfranc injuries are rare in children. In a Lisfranc joint injury, there is usually damage to the cartilage covering these bones. Injuries of the joint can range from complete tarsometatarsal displacement with associated … Unstable injuries should receive emergent Consultation for surgical intervention. Learning Radiology . The coronal plane is slightly oblique, perpendicular to C1. We provide subspecialized musculoskeletal and neurological MRI interpretation and we offer ProtonPACS, a leading PACS solution for hospitals, imaging centers and physician practices. The base of the 2 nd metatarsal keystones into the cuneiforms where there is … A Lisfranc injury will cause tenderness and pain surrounding the area that has been damaged. The doctor will probably also gently bend and twist the front of the foot to check if a person feels pain in their midfoot. In simple cases, doctors may ask the person to stand on the tiptoes of their injured foot. Magnetic resonance imaging (MRI) scan. Isolated fractures of the base of the 2nd metatarsal should alert practitioners to the presence of an injury to the Lisfranc complex. The Lisfranc injury is a popular topic in the radiology, orthopedic surgery, and emergency medicine literature, primarily due to the subtleties of the radiographic findings and potentially dire consequences of missed diagnoses. Radiographic features MRI The Lisfranc ligament can have a homogeneous low signal or striated appearance with low-to-intermediate signal intensity on MR images 1,3,4. oblique coronal sequences clearly display the transverse arch of the foot and clearly display the cross-section of the Lisfranc ligament Lisfranc joint ligamentous complex: MRI with anatomic correlation in cadavers. Fig. Radiographic assessment of isolated Lisfranc ligament injury may demonstrate widening of the Lisfranc interval (Figure 4A). It is possible to have a scan that is interpreted as normal, even when the joints are unstable and partially dislocated. These are often missed fractures, with up to 20% reported as misdiagnosed initially [1,2]. Contents ... Shoulder-Axial Imaging Plane Relevant Anatomy Humeral Head Bony Glenoid Clavicle ... R/O Occult Fracture. At the tarsometatarsal joint level, this displacement interrupts an imaginary line drawn on the dorsal surface of the foot 1-6.The sign is accentuated with plantar flexion and axial loading 2. 20 No. Comparison of magnetic resonance imaging with intraoperative findings. Although patients with Lisfranc sprains may incur ligamentous damage without diastasis [18], radiography should be the initial imaging modality in the setting of a suspected Lisfranc injury. Lisfranc Injuries – Symptoms, Causes & Treatment. Lisfranc ligament injuries. Most people need to wear a cast or boot for six to 12 weeks, and it can take a year or more to return to intense exercise like running. Radiography Foot with Weightbearing . Weight bearing radiographs are essential for evaluation of subtle injuries. B, Complete midsubstance tear ( arrow ) is seen as discrete fluid signal midsubstance defect. Timely and accurate diagnosis of the injury and early anatomical reduction and stabilization of the Lisfranc joint are crucial to avoid long-term sequelae and functional impairment. The low-impact midfoot sprain is called a Lisfranc injury; the high-impact injuries are calledLisfrancfracture-subluxationorLisfrancfrac-ture-dislocation. Homolateral injury concerns the displacement of all five metatarsal bones, or suggests a cube-like fracture. Dr. Ali and Dr. Chen are Fellows in Musculoskeletal Radiology, RadNet Management, Los Angeles, CA.Dr. Learn how to identify the Lisfranc ligament complex and the bifurcate ligament on MRI. A Lisfranc injury can involve any combination of fracture, joint dislocation, and/or injury to the stabilizing joint ligaments. This injury is diagnosed with a physical exam and various imaging scans. Diagnosis of Lisfranc injuries are made by a combination of both a medical examination and imaging such as X-Ray, MRI, or CT scan. 2017Feb;25(1):183-194. Other injuries affecting the Chopart joint complex, such as fracture-dislocation, will be … Diagnostic imaging is also helpful in evaluating ongoing symptoms … Learn More. Sonography reports in the radiology information system were searched from January 1999 through September 2007 for the key word “Lisfranc.” Cases were excluded if imaging was not available. computed tomography (CT) and magnetic resonance imaging (MRI) and some technique variants. This study aims to observe and describe the morphology and structure of Lisfranc ligaments using magnetic resonance imaging (MRI), in order to provide imaging reference for the diagnosis and repair of Lisfranc joint injuries. Lisfranc injuries are frequently missed. Disruption of the so-called Lisfranc ligament on MRI is highly suggestive of an unstable midfoot injury [ 3 ]. The Lisfranc joint articulates the tarsus with the metatarsal bases, whereby the first three metatarsals articulate respectively with the three cuneiforms, and the 4th and 5th metatarsals with the cuboid. 9 , 10 History Named after Jacques Lisfranc de Saint-Martin, a French field surgeon during the Napoleonic wars Definition Involving the tarso-metatarsal joint (TMTJ) Broad spectrum of injuries Sprain or subluxation Fracture Fracture-dislocation Epidemiology Approximately 0.2% of all fractures Accounts for more than 15% of all athletic injuries Second most common athletic … Lisfranc joint injuries are a rarity, accounting for less than 1% of all fractures, and make up 1 case per approximately 55,000 persons each year [1,2]bib8. In the middle region of your foot (midfoot), a cluster of small bones form an arch. *Weight bearing films can also be obtained to help diagnosis if uncertainly / as comparison, when force is applied through the TMT joint complex, there will be increased displacement of Lisfranc joint Several imaging studies have been published that define the role of MRI in the diagnosis of ligamentous injury of the foot and ankle [1, 6, 10–15]. Magnetic resonance imaging (MRI) is very useful for detecting soft-tissue injuries and ligamentous injuries. An MRI scan may be used to confirm a Lisfranc fracture. AJR Am J Roentgenol. (Redrawn with permission from Solan MC, Moorman CT III, Miyamoto RG, Jasper LE, Belkoff Magnetic resonance imaging (MRI) scan. Five of these long bones (the metatarsals) extend to the toes. A Lisfranc injury is an injury of the midfoot that can cause pain and impair your ability to walk. These imaging examinations can avoid the mis-diagnosis of ligamentous Lisfranc injuries. Charcot with superimposed osteomyelitis To determine whether osteomyelitis in a Charcot foot at MR imaging is present, follow the path of an ulcer or sinus tract to the bone and evaluate the signal intensity of the bone marrow. A Lisfranc injury is a significant injury that involves the midfoot. This test is … 20 No. You might need surgery. With injury one can see MCL thickening and increased signal intensity on MRI T2 Magnetic resonance imaging (MRI) may be beneficial in the instance of a subtle Lisfranc injury, particularly if a patient is unable to tolerate weightbearing radiographs. Magn Reson Imaging Clin N Am 2017 Feb;25(1):95-125. "Foot" MRIs should be treated as Ankle/Hindfoot/Midfoot MRIs until proven otherwise. diagnosis of injuries to the different ligaments of the Lisfranc complex, the distinction be-tween the Lisfranc ligament and the nearby plantar ligaments has not always been clear-ly made in the past. Multiple patients demonstrated dorsal TMT subluxation, which inherently represented a severely injured Lisfranc joint, given the coexistence of additional high-grade Lisfranc ligament injuries. Learning Radiology . A Lisfranc joint injury is a type of injury to the bones or ligaments, or both, in the middle part of your foot. Lisfranc injury •Defined as any bony or ligamentous injury that involves the tarsometatarsal joints of the foot •Failure to recognize these injuries can result in disability, deformity, and dysfunction. 5 MRI scan planning off the sagittal plane image. If there are clinical signs of a Lisfranc injury, obtaining weightbearing radiographs is recommended when J Bone Joint Surg Am. diagnosis of injuries to the different ligaments of the Lisfranc complex, the distinction be-tween the Lisfranc ligament and the nearby plantar ligaments has not always been clear-ly made in the past. Therefore, no imaging reference can be used for … This test is not required to diagnose a Lisfranc injury. Homepage; Seminars in Musculoskeletal Radiology Vol. – Written by Nabil Jomaah and Emad Almusa, Qatar. Magnetic resonance imaging (MRI) is very useful for detecting soft-tissue injuries and ligamentous injuries. Lisfranc Injury: Imaging Findings for this Important but Often-Missed Diagnosis Rajan T. Gupta, MD,a Rakhee P. Wadhwa, MD,b Thomas J. Learch, MD, b and Steven M. Herwick, MDa The Lisfranc injury is a popular topic in the radiology, orthopedic surgery, and emergency medicine literature, primarily due to the subtleties of the radiographic find- Clinical diagnosis can at times be challenging, due to the complex anatomy and multiple sites of potential injury. Lisfranc Injury in the Athlete. "Imaging in Lisfranc injury: a systematic literature review." Figure 1 Anatomic location of the dorsal, Lisfranc, and plantar ligaments. Forefoot (metatarsals & toes) MRIs for tendons & ligaments use "Ankle" protocol unless AOI is specifically in the forefoot. The axial plane follows the long axis of the metatarsals. Several imaging studies have been published that define the role of MRI in the diagnosis of ligamentous injury of the foot and ankle [1, 6, 10–15]. On MRI, Lisfranc injuries may be seen as high signal bone bruises, fractures, dislocations, increased signal within the ligaments, periligamentous edema, or ligament disruption Pearls Undiagnosed Lisfranc sprains can lead to chronic instability and early osteoarthritis When compared with CT and weightbearing radiography, magnetic resonance imaging (MRI) has an advantage in identifying partial ligament injuries and subtle ligament injuries. Tags: dislocation doctor fracture healthcare healthcare professional imaging lisfranc medicine mobile healthcare MRI mri scan nurses occupational medicine Premier premier radiology services rad tech radiologist radiology radiology tech teleradiology teleradiology experts urgent care xray xray tech xrays It is sometimes referred to as a midfoot sprain and it is often has a lengthy recovery time -especially compared to the average ankle sprain. The weight-bearing X-rays can indicate diastasis or malalignment in the midfoot that is associated with Lisfranc fracture-dislocations. J Bone Joint Surg Am 2009;91:892-899.) 2010 Dec;195(6):W447–455. ↑ Preidler, KW, Peicha, G, Lajtai, G, et al. Advanced functional imaging includes positron emission tomography (PET) as well as those MRI/CT technique variants that create image contrast based on a physiological parameter (for example, functional magnetic resonance imaging (fMRI). Fig. When Lisfranc fracture is suspected, radiographs of the foot are obtained. Further research with large sample size is still needed to confirm the conclusions. Skeletal radiology 49.1 (2020): 31-53. The Lisfranc joint itself is composed of the articulation between the first, second, and third metatarsals bones, and the cuneiform bones. Magnetic resonance imaging (MRI) or computed tomogram (CT) can be added to assess soft tissue structures or any intra-articular pathology [3]. Diagnosis is confirmed by radiographs which may show widening of the interval between the 1st and 2nd ray. 2/2016 Lisfranc Injury Imaging and Surgical Management Llopis et al.
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