ARRS 2022 Abstracts

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E1694. Tip of the Iceberg: Small Osseous Avulsion Fractures in the Foot Often Indicate Complex Osseoligamentous Injury Related to Midtarsal Sprain
Authors
  1. Matin Goldooz; Department of Radiology, University of Mississippi Medical Center
  2. Kathryn Nutter; Department of Radiology, University of Mississippi Medical Center
  3. Daniel Kennedy; Department of Radiology, University of Mississippi Medical Center
Background
Ankle inversion is one of the most common injuries in the musculoskeletal system. While midtarsal sprain can happen in more than 30% of patients with ankle inversion, the lack of familiarity with the condition may delay the prompt diagnosis. This can result in long-term pain, midfoot instability, and osteoarthritis in the future. Many of the midtarsal fractures are small and go unnoticed on plain film, therefore, it is essential for radiologists to be familiar with normal and abnormal appearance of the midtarsal joint and characteristic imaging findings of midtarsal sprains.

Educational Goals / Teaching Points
The goals of this exhibit are to review the midtarsal (Chopart) joint normal anatomy and stabilizing ligaments; discuss different mechanisms of midtarsal sprain, the resulting abnormalities, and consequences of missing the pathologies; illustrate the radiographic, CT, and MRI findings of normal midtarsal joint, midtarsal sprain, associated fractures, and ligamentous injuries.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this educational exhibit, we discuss different mechanisms of midtarsal sprain and its association with multiple midtarsal avulsion fractures and ligamentous injuries by illustrating the radiographic, CT, and MRI findings of these abnormalities.

Conclusion
A midtarsal sprain is a common pathology in patients with ankle inversion. However, the lack of familiarity with the condition can make the prompt diagnosis difficult and lead to multiple complications. Small osseous avulsion fractures in the foot often indicate complex osseoligamentous injury related to midtarsal sprain. A deeper understanding of the different mechanisms of midtarsal sprains and associated bone and ligamentous injuries is essential for timely diagnosis and preventing complications.