Assessment #1 case #11 vanderbilt

No evidence of fracture. The joint spaces are maintained. Soft tissue swelling overlying the dorsal aspect of the metatarsals. No radiopaque foreign body.

normal

bony fragment noted along the lateral aspect of the base of the 2nd metatarsal concerning for acute fracture. widening of the joint space between the 1st and 2nd metatarsals, suspicious for lisfranc injury

FINDINGS/IMPRESSION:

No acute fracture or dislocation. Alignment is normal. Joint spaces are maintained. The soft tissues are normal.

Nondisplaced fracture of the cuboid.

Mild soft tissue prominence on the superior aspect of the LEFT midfoot. No definitive acute fractures or malalignment.

No acute fracture or dislocation

Soft tissue swelling of the dorsal foot without underlying fracture of or osseous abnormality. Consider MRI if there is clinical concern for osteomyelitis, as standard radiograph is relatively insensitive.

No acute fracture or traumatic malalignment.

NAD

Left navicular fracture with mild soft tissue swelling.

Acute minimally displaced fracture of the posterior talar body. Joint spaes maintained.

No acute

Abnormality on the first metatarsal at IMP joint

normal

No fracture. ankle swelling.

Subtle thickening of the proximal fifth metatarsal diaphysis which could represent a healing stress fracture.
No acute fracture or malalignment.

Minimal soft tissue swelling over the dorsal aspect of the mid-foot without underlying fracture or radiopaque foreign body.

dorsal soft tissue swelling

No Acute fracture or dislocation. No soft tissue abnormality.

.

No fracture or malalignment. Joint spaces maintained.

acute mod displaced calcaneus fracture

normal

Soft tissue swelling. no acute fracture

No acute fracture or malalignment. No significant soft tissue swelling.

normal foot radiograph

No acute osseous abnormalities.

Acute mildly displaced fracture of the medial cuboid of the left foot with surrounding edema.

Fracture of the first cuneiform

Midfoot fx

Nl foot

Diffuse edema throughout the soft tissues of the foot. No fracture or malalignment. No radiopaque foreign body.

Irregular appearing ossific fragment at the lateral aspect of the base of the 2nd metatarsal concerning for avulsive injury. CT could evaluate further.

Mild swelling about the soft tissues of the forefoot.

Lisfranc injury

lisfranc

Lateral subluxation of second metatarsal at lisfranc joint, compatible with Lisfranc injury.

widening of the lisfranc interval with slight lateral subliaxation of the 2nd to 5th TMT joints. Consistent with acute divergent lisfranc sublaxation. consider CT to asses for additional injury.

Subtle widening of the space between the first and second metatarsal bases, with malalignment of the medial aspect of the second metatarsal bone with the intermediate cuneiform bone. Soft tissue swelling about the midfoot. These findings raise concern for Lisfranc ligament injury.

Increased widening of the Lisfranc joint space, with lateral deviation of the base of the 2nd metatarsal. No definite acute fracture.

Lisfranc fracture-dislocation

lisfranc widening, get WB image vs CT/MR

Widening of the 1st and 2nd metatarsal space and displacement of the 2nd metatarsal base laterally in relation to the middle cuniform. Mild swelling of the dorsum of the foot.
No fracture.

homolateral 2-5th metatarsal displacement indicative of underlying lisfranc fracture-dislocation

Subtle widening of the space between the first and second metatarsal bases, with malalignment of the medial aspect of the second metatarsal bone with the intermediate cuneiform bone. Soft tissue swelling about the midfoot. These findings raise concern for Lisfranc ligament injury.

Small linear osseous density lateral to the base of the second metatarsal likely represents a fracture fragment from a 2nd or 3rd metatarsal base fracture. Lateral displacement of the second and third metatarsals from the cuneiforms on AP view, and mild plantar forefoot displacement on lateral view concerning for Lisfranc injury.

Widening of lisfranc joint space, get weightbearing films

Lisfranc injury.

Widening of the space between the 1st and 2nd metatarsals, likely representing a lisfranc injury. Dorsal soft tissue swelling without definite fracture. Consider further evaluation with MRI.

Query nondisplaced intraarticular fracture of the proximal 2nd metatarsal, with possible disruption of the lisfranc ligaments. Recommend CT or weightbearing radiographs to further evaluate.

Offset of 2nd metatarsal alignment with medial cuneiform, increased offset between the 2nd and 3rd metatarsal with fleck sign consistent with acute fracture of the 2nd metarasal/lisfranc injury.

Recommend ct

Lateral displacement of the 1st MT with respect to the medial cuneiform and lateral displacement of the 2nd MT with respect to the intermediate cuneiform. Findings are consistent with a LisFranc dislocation and CT is recommended to evaluate for underlying fracture not well demonstrated on plain radiography. ST swelling about the forefoot.

widening of the second and third bases of the metatarsals, with associated calcific densities in the joint spaces, concerning for lisfranc joint injury.
Linear density with coritcal irregularities along the base of the 3rd metatarsal, which may reflect acute fracture.

general soft tissue swelling

Widening of the Lisfranc interval between the bases of the first and second metatarsals with a small ossific fragment visualized along the medial 2nd metatarsal base, raising concern for acute Lisfranc complex injury. Additional small fractures not detectable by plain radiograph are possible, and recommend CT of the foot to further evaluate.

Widening of the Lis-Franc interval concerning for occult fracture.

Acute Lisfranc joint injury w/dorsal foot swelling.

Acute widening of the Lisfranc interval concerning for ligamentous injury. No acute fracture. Soft tissue swelling about the midfoot.

Lateral offset of the 2nd metatarsal base with respect to the medial cuneiform with widening at the Lisfranc joint. No discernable fracture fragments. Recommend CT of the foot to evaluate for Lisfranc injury and occult fracture. Mild midfoot soft tissue swelling.

Acute minimally displaced fracture at the base of the 2nd metatarsal. Mild widening of the lisfranc joinc concerning for acute ligamentous injury. Soft tissue swelling about the medial midfoot. Recommend CT foot for further evaluation.

Widening of the 1st TMT joint and lateral subluxation of the 3rd metatarsal with respect to the medial cuneiform concerning for Lisfranc injury. Consider weight bearing radiographs or CT for further characterization. No definite fracture identified.

XX mm of lateral subluxation at the base of the second metatarsal with respect to the middle cuneiform concerning for lisfranc joint injury. Tiny ossific fragment along the medial base of the third metatarsal with lateral subluxation of the third metatarsal concerning for acute fracture. Recommend CT for further evaluation.

Query subtle lisfranc interval widening, with slight offset of the 2nd metarsal and intermediate cuneiform bones. There are also cortical irregularities at the base of the second and third metatarsals, which may represent acute fractures. Recommend follow up MRI if there is concern for ligamentous injury.

Mild widening of the Lisfranc interval with a fleck of bone between the base of the 1st and 2nd metatarsals concerning for acute Lisfranc joint injury. Recommend CT for further evaluation as there are likely additional radiographically occult fxs.

Acute Lisfranc’s fracture dislocation with widening of Lisfranc’s interval and X mm of lateral displacement of the 2nd metatarsal on the medial cunieform. Likely associated fracture at the base of the second metatrsal. Reccommend CT for futher evalustion.

lis franc fracture

Lis Franc

Avulsion fracture of the lateral base of the 2nd metatarsal. Lateral subluxation of the 3rd metatarsal at the 3rd TMT joint. Lateral subluxation of the 2nd metatarsal at the middle cuneiform. These findings are concerning for Lisfrank ligament injury. Soft tissue swelling about the dorsal forefoot.

Lateral subluxation of the 2nd metatarsal in relation to the middle cuneiform, concerning for lisfranc injury. There is a linear osseous density lateral to the base of the second metatarsal, concerning for acute avulsion fracture.

findings concerning for acute lisfranc injury with homolateral lisfranc dislocation and a small ossific fragment at the base of the 2nd metacarapal suggesting an acute fracture.

Widening of the Lisfranc joint concerning for ligamentous injury. MRI could further evaluate if clinically indicated.

Widening of lisfranc joint with medial displacement of the 2nd metatarsal with respect to the middle cuneiform. increased space for between the 2nd and 3rd metatarsals with lateral displacement of the 3rd metatarsal. These findings are concerning for lisfranc injury.

ossific fragments between the bases of the 2nd and 3rd metatarsals and middle and medial cuneiform likely represent avulsion fractures.

No acute fracture.

Lateral subluxation of the 2nd TMT consistent with list franc injury, recommend MRI for further evaluation.

liosfranc homolateral

Acute lisfranc fracture. Comminuted fracture of the lateral cuneiform bone. Soft tissue swelling.

lisfranc joint widening, likely lisfranc injury

Avulsion fracture of the 3rd metatarsal base.

Questionable widened interval between the 1st and 2nd metatarsal bases and off set of the 2nd metatarsal base and intermediate cuneiform which could be seen with a lisfranc injury. CT could further evaluate.

Widening of the lisfranc interval with acute fracture of the 2nd metatarsal base with asymmetry of the alignment of the 2nd metatarsal/middle cuneiform interface, concerning for lisfranc injury.
Dorsal foot soft tissue swelling.

Lateral displacement of the second through fifth metatarsals on AP view, concerning for Lisfranc injury. Recommend CT for further evaluation as well as evaluation for non-radiographically apparent fractures.

Subtle lateral translation of the second metatarsal relative to the intermediate cuneiform, which raises concern for a Lisfranc injury. Recommend orthopedics consultation.

Findings concerning for Lisfranc injury with small avulsion fracture along the medial aspect of the second metatarsal base with slight lateral subluxation of the second metatarsal base relate to the middle cuneiform. Additional small ossific fragments adjacent to the medial aspect of the third metarsal, medial cuneiform, and lateral cuboid concerning for additional acute fractures. Mild soft tissue swelling of the forefoot. Consider CT for further evaluation.

lisfranc

Widening of Lisfranc interval c/f ligamentous injury.

Acute lisfranc injury as evidenced by diastasis of the 1st and 2nd meetatarsal bases and possible avulsion fx of the 2nd metatarsal base (fleck sign). Consider weight bearing view for confirmation.

Lisfranc fracture dislocation with midfoot soft tissue swelling.

Lisfranc

Widening at the Lisfranc ligament suspicious for soft tissue injury. This could be further assessed with weightbearing radiographs or MRI.

Lis franc injury

Widening of the Lis Franc joint. Homolateral displacement of metatarsal 2-5.

Lisfranc injury, homolateral, although limited evaluation on non weight bearing exam.

Widening of the Lisfranc joint with lateral displacement of the 2nd through 5th metatarsals. These findings are concerning for acute Lisfranc injury. Recommend orthopedic consult.

Possible widening of the interval between the first and second metatarsal bases. Lucency at the anteriorlateral cuboid, suspicious for fracture. Additional fragment between the second and third metatarsal bases, concerning for avulsion. Findings concerning for Lisfranc fracture dislocation. CT could further assess.

Acute fracture at the medial base of the third metatarsal with xx displacement.

Slight offset of the 2nd metatarsal base with the middle cuneiform with lateral deviation of the metatarsal, concerning for lisfranc ligamentous injury. Questioned cortical irregularity of the antero-lateral aspect of the medial cuneiform may represent associated avulsion fracture.

Questioned osseous fragment between the distal lateral cuneiform and the base of the 4th metatarsal may represent fracture fragment.

Recommend CT to further characterize.

Widening of the medial aspect of the 2nd TMT joint concerning of an acute lisfranc injury. CT of the foot is recommended for further evaluation.

Widening of the lisfranc interval with likely small non-displaced fractures of the intermediate cuneiform and 2nd proximal metatarsal. Findings are concerning for acute Lisfranc injury. Recommend further evaluation with CT or MRI.

Widening of the lisfranc joint concerning for lisfranc injury. Recommend CT.

Acute minimally displaced fractures of the base of the second and third metatarsals with mild widening of the lisfranc interval and lateral subluxation of the second metatarsal; indicative of acute lisfranc fracture/subluxation.

lis

Joint space widening between the bases of the 1st and 2nd metatarsals with alignment concerning for Lisfranc injury.

There is subluxation of the 2nd and 3rd metatarsal bone with corresponding articular surface. Findings concerning for Lisfranc injury.

Homolateral lisfranc injury.

There is a Lisfranc fracture resulting in homolateral dislocation. There is generalized soft tissue edema.

Three radiographic views of the left foot are provided.

The AP view demonstrates mild malalignment of the second metatarsal relative to the middle cuneiform with widening of the Lisfranc joint. A true measurement is not able to be provided with the given software. There is minimal dorsal displacement of the second metatarsal. Osseous mineralization is normal. A radiographic C-sign is present about the talus and calcaneus on the lateral view. No talar beaking is present.

There is osseous fusion of the left fifth distal and middle phalanx.

Mild soft tissue edema of the left foot is present.

Impression:
1. Mild malalignment of the second metatarsal relative to the middle cuneiform and widening of the Lisfranc jiont may represent a Liz Franc ligamentous injury. Given the subtle findings on this radiograph, MRI of the foot is recommended.
2. Radiographic C-sign on the lateral view could represent talocalcaneal coalition. If there is clinical concern, CT of the foot is recommended.

Lisfranc injury

c/f lisfranc rec standing view or ct

Lisfranc injury with lateral subluxation of the 2nd-5th TMT joints

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Mild widening between the intermediate cuneiform and the second metatarsal head, suggestive of lis franc injury.

lisfranc

Widening and malalignment of the LisFranc joint