medial sesamoid of metatarsal head ( RID2987 )
There is marrow edema throughout the accessory ossicle (sesamoid) embedded in the medial plantar plate of the 2nd MTPJ, with subchondral marrow edema at the adjacent MT head and MTP effusion. The plantar plate is intact (see distal insertion in short axis). There is plantar pericapular edema in proximity to the sesamoid. This is sesamoiditis of the 2nd MT sesamoid (never seen it). Fortuitiously, we see the normal appearance in MRI 5 years earlier: note the shift of the flexor tendons just lateral to midline, which is probably normal (though there is no reference), related to the sesamoid. According to Dr. Nwawkas reference, this person is unusual, having sesamoids of all 4 lesser metatarsals...and now one hurts! [ Article ]
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