Department of Emergency Medicine

UMEM Educational Pearls

Category: Orthopedics

Title: 20 yo running back with foot pain

Keywords: foot injury (PubMed Search)

Posted: 11/25/2023 by Brian Corwell, MD
Click here to contact Brian Corwell, MD

Question

https://prod-images-static.radiopaedia.org/images/10520267/02680740bc93e7997528a865940506_big_gallery.jpeg

Answer

The fleck sign of the foot is a small bony fragment seen in the Lisfranc joint space.

The space between the bases of the first and second metatarsal

This finding is associated with an avulsion of the Lisfranc ligament

https://static.wixstatic.com/media/187e61_0ecf85a422ec437fb7d90fa7b0225516~mv2_d_1500_1403_s_2.jpg/v1/fill/w_1110,h_1038,al_c,q_85,usm_0.66_1.00_0.01,enc_auto/187e61_0ecf85a422ec437fb7d90fa7b0225516~mv2_d_1500_1403_s_2.jpg

https://static.wixstatic.com/media/187e61_f5852bc13b3348f789bd02d0e0929d23~mv2_d_1529_1348_s_2.jpeg/v1/fill/w_1110,h_978,al_c,q_85,usm_0.66_1.00_0.01,enc_auto/187e61_f5852bc13b3348f789bd02d0e0929d23~mv2_d_1529_1348_s_2.jpeg

Lisfranc Injuries

MVAs, falls from height, and athletic injuries
- Axial load through a hyper plantar flexed foot
- https://www.researchgate.net/profile/Daniel-Lorenz-2/publication/236207924/figure/fig6/AS:668351428845569@1536358806103/Typical-mechanism-for-a-low-energy-velocity-Lisfranc-injury-Figure-courtesy-of-MMG-via.png

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