Presentation
Increase in pain at the medial longitudinal arch of the right foot. History RA.
Patient Data
There is mild lateral subluxation at the articulation between the intermediate cuneiform and 2nd metatarsal with loss of joint space and increased subchondral sclerosis. This likely reflects early Lisfranc dislocation and given the midfoot background arthropathic features, the possibility of a neuropathic joint disease or Charcot foot is raised. Degenerative changes with loss of joint space and subarticular sclerosis of the joint between navicular and cuneiforms.
No erosive arthropathy to suggest rheumatoid arthritic changes. There is severe flattening of the medial longitudinal arch on the weightbearing images.
IMPRESSION
Midfoot arthropathy with Lisfranc subluxation and pes planus raising concerning for Charcot foot.
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