Can ultrasound of plantar plate have normal appearance with a positive drawer test?

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dc.contributor.authorFernandes, Eloy de Avila [UNIFESP]
dc.contributor.authorMann, Tania Szejnfeld [UNIFESP]
dc.contributor.authorPuchnick, Andrea [UNIFESP]
dc.contributor.authorTertulino, Franklin de Freitas [UNIFESP]
dc.contributor.authorCannato, Camila Testoni [UNIFESP]
dc.contributor.authorNery, Caio [UNIFESP]
dc.contributor.authorCorrea Fernandes, Artur da Rocha [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:40:10Z
dc.date.available2016-01-24T14:40:10Z
dc.date.issued2015-03-01
dc.description.abstractObjectives: the aims of this study were (1) to evaluate the reliability of ultrasound (US) examination in the identification and measurement of the metatarsophalangeal plantar plate (MTP-PP) in asymptomatic subjects and (2) to establish the correlation of US findings with those of physical examination and magnetic resonance imaging (MRI), once it is an important tool in the evaluation of the instability syndrome of the second and third rays.Materials and Methods: US examinations of the second and third MTP-PPs were performed in eight asymptomatic volunteers, totaling 32 MTP joints, by three examiners with different levels of experience in musculoskeletal US. Plantar plate dimensions, integrity and echogenicity, the presence of ruptures, and confidence level in terms of structure identification were determined using conventional US. Vascular flow was assessed using power Doppler. US data were correlated with data from physical examination and MRI.Results: MTP-PPs were ultrasonographically identified in 100% of cases, always showing homogeneous hyperechoic features and no detectable vascular flow on power Doppler, with 100% certainty in identification for all examiners. There was excellent US inter-observer agreement for longitudinal measures of second and third toe MTP-PPs and for transverse measures of the second toe MTP-PP. the MTP drawer test was positive for grade 1 MTP instability in 34.4% of joints with normal US results. Transverse MTP-PP measures were significantly higher in individuals with positive MTP drawer test. US measures and characteristics of MPT-PPs were positively correlated with those of MRI.Conclusions: US is efficient in identifying and measuring MPT-PPs and may complement physical examination. A grade 1 positive MTP drawer test may be found in asymptomatic individuals with normal MPT-PPs, as assessed by imaging. (C) 2014 Elsevier Ireland Ltd. All rights reserved.en
dc.description.affiliationUniversidade Federal de São Paulo, EPM Unifesp, Dept Diagnost Imaging, Escola Paulista Med, São Paulo, Brazil
dc.description.affiliationEPM Unifesp, Dept Orthoped & Traumatol, Foot & Ankle Grp, São Paulo, Brazil
dc.description.affiliationEPM Unifesp, Dept Diagnost Imaging, São Paulo, Brazil
dc.description.affiliationEPM Unifesp, Dept Surg, São Paulo, Brazil
dc.description.affiliationEPM Unifesp, Dept Orthoped & Traumatol, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, EPM Unifesp, Dept Diagnost Imaging, Escola Paulista Med, São Paulo, Brazil
dc.description.affiliationUnifespEPM Unifesp, Dept Orthoped & Traumatol, Foot & Ankle Grp, São Paulo, Brazil
dc.description.affiliationUnifespEPM Unifesp, Dept Diagnost Imaging, São Paulo, Brazil
dc.description.affiliationUnifespEPM Unifesp, Dept Surg, São Paulo, Brazil
dc.description.affiliationUnifespEPM Unifesp, Dept Orthoped & Traumatol, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent443-449
dc.identifierhttp://dx.doi.org/10.1016/j.ejrad.2014.11.036
dc.identifier.citationEuropean Journal of Radiology. Clare: Elsevier B.V., v. 84, n. 3, p. 443-449, 2015.
dc.identifier.doi10.1016/j.ejrad.2014.11.036
dc.identifier.issn0720-048X
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/38830
dc.identifier.wosWOS:000349177800017
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofEuropean Journal of Radiology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectMetatarsophalangeal plantar plateen
dc.subjectUltrasounden
dc.subjectMagnetic resonance imagingen
dc.subjectMetatarsalgiaen
dc.subjectMetatarsophalangeal jointen
dc.titleCan ultrasound of plantar plate have normal appearance with a positive drawer test?en
dc.typeinfo:eu-repo/semantics/article
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