Second metatarsophalangeal joint arthrography: a cadaveric correlation study

J Foot Ankle Surg. Jul-Aug 2004;43(4):231-40. doi: 10.1053/j.jfas.2004.05.009.

Abstract

Arthrography of the second metatarsophalangeal joint is an important diagnostic tool to evaluate the integrity of the plantar plate and to aid in the decision process for surgical intervention. A variety of filling patterns have been identified with lesser metatarsophalangeal joint arthrography and their significance with soft-tissue pathology remains to be completely understood. The purpose of this cadaveric study was to evaluate dye patterns in a series of arthrograms of the second metatarsophalangeal joint and to correlate them with identifiable anatomic lesions or structural variants. Thirty-nine cadaveric specimens (including 28 matched pairs) underwent second metatarsophalangeal joint arthrography with a colored radiopaque dye. Arthrographic findings were observed and recorded. Specimens exhibiting dye extravasation outside of the capsular constraints of the joint were dissected to discover any soft-tissue abnormalities. Twenty-one percent of specimens exhibited abnormal extravasation of dye outside of the joint capsule. A plantar plate tear was identified in 2 of these specimens. Filling of the first intermetatarsophalangeal bursa occurred in 6 specimens. However, because this finding was identified in 2 matched pairs, an anatomic variance is suggested rather than a pathologic entity. This cadaveric study shows that anatomic variances exist concerning the second metatarsophalangeal capsule and that arthrography should be correlated with the clinical scenario.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthrography*
  • Bursa, Synovial / injuries
  • Cadaver
  • Coloring Agents
  • Extravasation of Diagnostic and Therapeutic Materials / etiology
  • Humans
  • Joint Capsule / diagnostic imaging*
  • Metatarsophalangeal Joint / diagnostic imaging*
  • Middle Aged
  • Rupture

Substances

  • Coloring Agents