Category: Orthopedics
Keywords: foot fracture, radiology (PubMed Search)
Posted: 9/14/2019 by Brian Corwell, MD
(Updated: 12/9/2024)
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Imaging of Lisfranc Injuries
Tarsometatarsal fracture-dislocation
Anatomy
3 Columns of the midfoot, divided by the tarsometatarsal joints
The Lisfranc ligament
- Extends from the 2nd MT to the medial cuneiform
- Critical to structure and stabilization of the 2nd MT and the midfoot arch
Imaging
Plain films: AP/lateral/oblique
Consider weight bearing view with contralateral comparison if high suspicion
CT: Can be useful to confirm abnormal plain films
MRI: not done in ED but can be used to diagnose pure ligament injuries
Below is a review of the lines of the foot which will ensure not missing this diagnosis. May be helpful to review with sample imaging.
Plain films findings: https://prod-images.static.radiopaedia.org/images/49189279/86408d5bae08ab80ae9ef377337ab7_big_gallery.jpeg
On AP view:
On Lateral view:
On the Oblique view:
Remember that the lateral margin of the 5th MT can project lateral to the cuboid (up to 3 mm)
Lines drawn on 2 view foot for review
https://radiopaedia.org/cases/lisfranc-ligament-normal-alignment
Orthobullets.org