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Midfoot & Forefoot

Midfoot & Forefoot

A. Alignment

  • The medial border of the 2nd MT should align with the medial border of the intermediate cuneiform.
  • The medial border of the of the 3rd MT should align with the medial border of the lateral cuneiform.
  • Look for Lis Franc injury: widening of the Lis Franc interval + loss of alignment b/w the 2nd & 3rd MT bases.

B. Bones

  • Differentiate between avulsion fractures of the 5th MT base (fracture line orientated in the transverse axis) vs. unfused apophysis (separation line orientated in the longitudinal axis).
  • Jones fracture.
  • Stress (March) fracture: 2nd & 3rd MT most commonly affected. 4 appearances - transverse crack, subtle callus, profuse callus, normal radiograph.

S. Soft tissue

  • Difficult to interpret.


1. Goodman, L. and Felson, B. (2015). Felson's principles of chest roentgenology. 3rd ed. Philadelphia, PA: Elsevier, Saunders.
2. Dähnert W. Radiology Review Manual. LWW. (2011) ISBN:1609139437. Read it at Google Books - Find it at Amazon
3. Elizabeth Puddy, Catherine Hill; Interpretation of the chest radiograph, Continuing Education in Anaesthesia Critical Care & Pain, Volume 7, Issue 3, 1 June 2007, Pages 71–75, https://doi.org/10.1093/bjaceaccp/mkm014

Ⓒ A. Manickam 2018

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