Ask a Neurologist. Get Answers to Your Neurology Questions.
MRI Foot Without Contrast (Right) CLINICAL HISTORY: Foot pain. Possible 2nd metatarsal fracture versus Freiberg's infraction.
TECHNIQUE Multiplanar, multisequence MR images of the right forefoot were acquired on a 3 Tesla wide bore GE magnet with high performance gradients. No intravenous contrast was administered.
COMPARISON No prior study available for comparison.
OSSEOUS STRUCTURES: There is subchondral marrow edema and cystic change within the 2nd metatarsal head, with mild flattening of the articular surface (series 8 and 9, image 17), which could represent chronic Freiberg's infraction or a chronic osteochondral impaction injury with superimposed degenerative changes. No displaced fracture identified. There is also moderate degenerative arthropathy spanning 1st metatarsal headtibial (medial) hallux sesamoid articulation, and minimal degenerative changes spanning the 1st metatarsal headfibular hallux sesamoid articulation. Minimal 1st and mild 2nd MTP joint fluid is noted. No widening of the Lisfranc interval identified.
SESAMOIDS: The hallux sesamoid complex is anatomically aligned. Degenerative changes are noted spanning the 1st metatarsal headhallux sesamoid articulations as detailed above. No avascular necrosis identified.
PLANTAR PLATES: There is degeneration and minimal chronic fraying of the tibial hallux sesamoidphalangeal ligament and 1st plantar plate. The 2nd through 5th plantar plates are intact.
BURSAE: No metatarsal interspace bursitis identified.
MORTON NEUROMA: Minimal infiltration of the 2nd metatarsal interspace is noted extending plantar, compatible with nonspecific fibrosis versus a minimal Morton neuroma (series 6, image 19).
MUSCLES: Normal muscle bulk of the imaged right forefoot. TENDONS: The imaged flexor and extensor tendons are intact.
SOFT TISSUES: Minimal nonspecific subcutaneous edema is noted within the forefoot, most prominent dorsomedially and surrounding 2nd MTP joint.
CONCLUSION: MRI Foot Without Contrast (Right)
1. Subchondral marrow edema and cystic change within the 2nd metatarsal head, with flattening of the articular surface. Differential considerations include the sequela of chronic Freiberg's infraction, or a chronic osteochondral impaction injury with superimposed degenerative changes.
2. Degenerative arthropathy spanning the 1st metatarsal head and hallux sesamoid articulations as detailed above.
3. Infiltration of the 2nd metatarsal interspace fat, which could represent nonspecific fibrosis or a minimal Morton neuroma.
4. Lower grade and nonacute incidental findings as detailed in the body of the report.
Thank you for the opportunity to participate in the care of your patient. Please contact us if we can be of further assistance.
Chad Silverberg, D.O. Progressive Radiology
Electronically signed by: Chad Silverberg, D.O. on 5/4/2015 10:03 AM EDT
Patient: MIDDLETON, LELAND Chart: 129843 Reading Doctor: Chad Silverberg, D.O. Referral Fax: 2026860932 CPT: 73718
A PT at Fasttrack therapy has been helping and she recommended an orthopedic who does PRP- went to see him and they think this will help regenerate my toe issue. I went to my podiatrist the the other day and he said PRP is kind of outdated and he has the right answer w/PX 50 (placenta tissue matrix)- or Amniofix. He says both are better than PRP- one shot in toe as opposed to multiple shots,etc. He said amniofix and Placenta tissue matrix are superior- I don't know what to think and am having trouble finding the answer- all of which are supposed to regenerate my cartilage or something like that- otherwise my podiatrist says I could do surgery at some point. Very confusing
ok good idea- I may have a another question once I ask this to them.