Fluoroscopy Foot In addition to routine radiographs, fluoroscopy has been suggested in assessment of a hallux MTP joint injury with direct fluoroscopic evaluation of sesamoid tracking distally with great toe extension at the MTP joint on forced dorsiflexion lateral view or fluoroscopy [29]. Variant 5: Adult or child older than 5 years of age. Acute trauma to the foot. Suspect Lisfranc injury, tendon injury, or occult fracture or dislocation. Radiographs are normal or equivocal. Next imaging study. CT Foot Lisfranc Injury CT has been advocated as the primary imaging technique in acute hyperflexion injury and high-energy polytrauma (especially if the patient is not able to bear weight) [33,38,41-45]. CT is useful in demonstrating the multiple metatarsal and cuneiform fractures that can be associated with a ligamentous Lisfranc injury [21,22,33]. CT is typically used for preoperative planning for fracture treatment and evaluation. In the patient with a suspected Lisfranc injury and normal radiographs, the literature supports further advanced imaging by MRI and CT [21,33,43,46]. Acute Tendinous Injury CT imaging has been shown to be an effective way of documenting various tendon entrapment and dislocations, in particularly peroneal dislocations and peroneal retinacular injuries, which are associated with comminuted calcaneal fractures [47-50]. MRI Foot MRI can show osseous injuries that are not visible radiographically including fractures and high-grade contusions associated with prolonged recovery times in elite athletes [51]. MRI can demonstrate ligamentous and osseous Acute Trauma to the Foot injuries in midtarsal (Chopart) sprains, which frequently accompany acute ankle injuries [52,53]. If radiographs are negative, MRI can be obtained in select patients with forefoot pain because of its increased sensitivity for the early detection of metatarsal head subchondral fracture [54].
Acute Trauma to the Foot. Fluoroscopy Foot In addition to routine radiographs, fluoroscopy has been suggested in assessment of a hallux MTP joint injury with direct fluoroscopic evaluation of sesamoid tracking distally with great toe extension at the MTP joint on forced dorsiflexion lateral view or fluoroscopy [29]. Variant 5: Adult or child older than 5 years of age. Acute trauma to the foot. Suspect Lisfranc injury, tendon injury, or occult fracture or dislocation. Radiographs are normal or equivocal. Next imaging study. CT Foot Lisfranc Injury CT has been advocated as the primary imaging technique in acute hyperflexion injury and high-energy polytrauma (especially if the patient is not able to bear weight) [33,38,41-45]. CT is useful in demonstrating the multiple metatarsal and cuneiform fractures that can be associated with a ligamentous Lisfranc injury [21,22,33]. CT is typically used for preoperative planning for fracture treatment and evaluation. In the patient with a suspected Lisfranc injury and normal radiographs, the literature supports further advanced imaging by MRI and CT [21,33,43,46]. Acute Tendinous Injury CT imaging has been shown to be an effective way of documenting various tendon entrapment and dislocations, in particularly peroneal dislocations and peroneal retinacular injuries, which are associated with comminuted calcaneal fractures [47-50]. MRI Foot MRI can show osseous injuries that are not visible radiographically including fractures and high-grade contusions associated with prolonged recovery times in elite athletes [51]. MRI can demonstrate ligamentous and osseous Acute Trauma to the Foot injuries in midtarsal (Chopart) sprains, which frequently accompany acute ankle injuries [52,53]. If radiographs are negative, MRI can be obtained in select patients with forefoot pain because of its increased sensitivity for the early detection of metatarsal head subchondral fracture [54].