plantar plate of metatarsophalangeal joint ( RID3134 )
This is a case of endstage 2nd MTP plantar plate tear with 2nd MTP instability as evidenced by the crossover toe deformity (1st slide). The tear is not clearly visible and is presumably chronic and scarred, yet the patient is experiencing severe, worsening pain (this is an instance in which correlated signs of plantar plate tear make the diagnosis). There is marked reactive 2nd toe marrow edema and prominent enthesopathic spurring at the lateral 2nd plantar plate insertion (blue arrow). Note the HAV and elongated 2nd MT in slide 1. In slide 3 there is superimposed lateral capsule and, likely, 2nd DI tear. T1W images show the pseudoneuroma which is distinguished from a true neuroma in that it hugs the plantar lateral capsule, is not centered in the plantar webspace and is seen in the context of plantar plate and lateral capsule tear.
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