Navegando por Palavras-chave "Metatarsophalangeal Joint"

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    Estudo das alterações radiográficas e de ressonância magnética relacionadas à lesão da placa plantar metatarsofalângica do segundo pododáctilo
    (Universidade Federal de São Paulo (UNIFESP), 2020-07-02) Mann, Tania Szejnfeld [UNIFESP]; Fernandes, Eloy De Avila [UNIFESP]; Universidade Federal de São Paulo
    Objective: To investigate whether the protrusion measurements of the second metatarsal, performed using Coughlin’s method, on radiographs and MRI images are related and reproducible. Check if the greater relative length of the second metatarsal is associated with metatarsophalangeal plantar plate lesion. Evaluate, through forefoot MRI, the prevalence of degenerative lesions of the plantar plate of the 2nd metatarsophalangeal joint in individuals with metatarsalgia and describe its main characteristics in MRI. Methods: Radiographic images of the feet with load and forefoot MRI of 166 consecutive patients (211 feet) were retrospectively evaluated. Two independent observers measured the protrusion of the second metatarsus using Coughlin’s method. Using MRI images, the plantar plate of the second toe was independently assessed by the observers, and classified as normal, complete rupture or degenerative lesion. Results: The measurements of the second metatarsal protrusion performed by the two observers showed almost perfect correlation (r = 0.882), however, it was found that the measurements obtained on the radiograph are approximately 35% greater than those obtained on MRI. There was a statistical difference in the measure of protrusion of the second metatarsal between the normal and ruptured groups. Using a ROC curve, it was possible to determine that the protrusion of 5.47 mm, measured on radiography, or 3.14 mm, on MRI, is associated with plantar plate lesion. Degenerative lesion of the plantar plate, identified on MRI as a heterogeneous thickening or thinning of the plantar plate, was best observed in coronal intermediate-weighted sequences, and recorded in 24% of our sample. The presence of pericapsular fibrosis below the transverse intermetatarsal ligament is an indirect finding related to this lesion. Conclusion: We found that the protrusion measurements of the second metatarsal, performed using Coughlin’s method on radiographs and MRI, are related and reproducible, considering that this measure is 35% lower in MRI than radiography. It was also verified that the protrusion of the second metatarsal is a factor that favors the lesion of the metatarsophalangeal plantar plate of the second toe. Degenerative lesions of the plantar plate were identified in a quarter of our sample, being best seen in coronal intermediate-weighted images, and pericapsular fibrosis below the transverse intermetatarsal ligament, best visualized in T1-weighted coronal-short axis, was the indirect finding that most related to this injury.