Best Practice Case Studies-Case 125 Asset 4 Ultrasound: Forefoot

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Video Summary

The speaker presented a practical ultrasound case of a 56-year-old female walker with lesser metatarsalgia and emphasized a protocol-driven approach to forefoot scanning. After reviewing radiographs, the exam assessed the MTP joints, interspaces, plantar plates, and fat pad using long- and short-axis views plus Doppler and dynamic maneuvers. The patient showed second MTP synovial/capsular hypertrophy, a second interspace neuroma-bursal complex, a partial full-thickness plantar plate tear with bony irregularity at the proximal phalanx insertion, and fat pad fibrosis—together described as “second metatarsal syndrome.” The speaker stressed that short-axis imaging often reveals findings missed in long axis, and that ultrasound can detect pathology not always seen on MRI. The report format and correlation with clinical tenderness were also reviewed. The patient improved after surgery.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 125

Topic Foot

Keywords

4th Edition

4th Edition, Case 125

Foot

ultrasound forefoot scan

second metatarsal syndrome

plantar plate tear

MTP joint synovitis

Morton neuroma bursal complex

fat pad fibrosis