plantar plate of metatarsophalangeal joint ( RID3134 ) Midline Longitudinal image shows 2nd PP, but paracentral and lateral images only show large enthesophytes and no PP. Short axis images show marked soft tissue thickening and enthesophytes, with pericapsular fibrosis eccentrically encroaching on echogenic fat in the interspace. If you dont compress firmly, this can look centric. My tech measured this in the long axis and told me it was a neuroma....that requires you to scan the patient. At that time, you can see the tibial deviation of the toe and learn that it wasnt always like that. Sometimes you can see that tenderness is at the lateral base of the toe (usually 2nd). See normal images for comparison. XRs in last slide.