E2672. Don’t Step On It - Imaging of Anatomy and Traumatic Injury of the Lisfranc Joint: What Every Resident Should Know
Authors
Brendan Franz;
Henry Ford Health
Kyle Dammeyer;
Henry Ford Health
Gauthier Dongmo;
Wayne State University
Chad Klochko;
Henry Ford Health
Joseph Craig;
Henry Ford Health
Background
While Injury to the Lisfranc joint is uncommon, prompt diagnosis is imperative to ensure proper management. Radiographic images obtained in the emergency department often demonstrate key findings that can influence outcomes. While some of these findings maybe more obvious, subtle cases can pose a challenge with potentially increased morbidity if they are incorrectly diagnosed. Proper use of initial radiographic imaging and judicious use of cross-sectional imaging can aid in early diagnosis and treatment of Lisfranc injuries.
Educational Goals / Teaching Points
Review of the normal Lisfranc joint on radiography, CT and MRI with relevant anatomic landmarks. Relevant pearls for identifying subtle disruptions in normal anatomy. Overview of common mechanisms of injury involving the Lisfranc joint including high- and low-impact injuries. Demonstration of imaging patterns of common injury as seen on radiographs and cross-sectional imaging. Review of clinical treatment options including surgical and non-surgical correction.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
A review of the normal anatomy of foot radiography including key anatomic features that may suggest subtle ligament disruption, and demonstration of the Lisfranc joint on CT and MRI including the correct plane of imaging ands demonstration of traumatic pathology.
Conclusion
Radiographic images obtained in the acute setting can demonstrate a range of findings indicating injury to the Lisfranc ligament, some of which maybe subtle. We reviewed the normal appearance of the Lisfranc ligament on radiography and cross-sectional imaging. Classic to more subtle radiographic findings were reviewed with cross-sectional correlation. Additionally, we covered the common mechanisms of injury as well as treatment options. Timely diagnosis of Lisfranc disruption improves patient outcomes and reduces long-term morbidity.
