plantar plate of metatarsophalangeal joint ( RID3134 )
Current MRI shows chronic avulsion at plantar lateral base of prox phalanx (white arrow) which is presumably unstable given the degree of BME. There is tearing at the conjoint insertion of the extreme lateral plantar plate and lateral phalangeal collateral ligament / lateral capsule (yellow arrow). Fluid in the joint and tendon sheath suggests pathological communication between the two. Note the eccentric plantar lateral pericapsular soft tissue thickening /edema (red arrowheads) encroaching on fat planes in the 2nd interspace; this is pseudoneuroma.
The tech chose to do additional oblique ax plane images along the axis of the proximal phalanges, which are much nicer than the std straight axial plane. Baseline post trauma MRI is included in final slide.
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