Step-off sign

Last revised by Andrew Murphy on 1 Feb 2020

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. 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.

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Cases and figures

  • Case 1
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  • Case 2
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