Midtarsal sprains are less common than collateral ligament injuries of the ankle and are often overlooked both clinically and radiologically. On the initial x-ray, there is a very good clue with a ROI indicated by the radiographer indicating symptoms in the midtarsal region rather than at the ankle joint. Midtarsal injuries can often be occult on plain radiographs. On MRI, plantar talar head marrow edema (+/- microtrabecular injury) is a really good clue that the midtarsal ligaments may be injured.