Midfoot ligametous injury (ultrasound)

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Foot injury due to a fall on the ground while playing cricket. Left mid-foot dorsal pain and swelling. Negative radiograph for a fracture.

Patient Data

Age: 20 years
Gender: Female
ultrasound

Small effusion in the ankle joint anterior recess. Normal fibrillar echopattern of the anterior talofibular and calcaneofibular ligaments. Hypoechoic thickening of the dorsal calcaneocuboid ligament without bony avulsion the calcaneal insertion. A cuboid bony avulsion of the calcaneocuboid band of the bifurcate ligament. Normal calcaneonavicular band of the bifurcate ligament. Normal echopattern of the dorsal talonavicular ligament. No avulsion fracture at the peroneus brevis insertion.

Comparison with normal contralateral foot was done for dorsal calcaneocuboid and bifurcate ligaments.

Cine-loops of affected foot.

Case Discussion

Case shows midtarsal injury involving dorsal calcaneocuboid ligament and calcaneocuboid band of the bifurcate ligament.

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