Luca Maria Sconfienza MD, Presenter: Nothing to Disclose

Francesca Lacelli MD, Abstract Co-Author: Nothing to Disclose

Giovanna Grillo MD, Abstract Co-Author: Nothing to Disclose

Giovanni Serafini MD, Abstract Co-Author: Nothing to Disclose

Giacomo Garlaschi MD, Abstract Co-Author: Nothing to Disclose

Enzo Silvestri MD, Abstract Co-Author: Nothing to Disclose

Plantar plate tears are quite a common cause of misknown forefoot pain. The aim of our paper is to describe the normal and pathologic appearance of plantar plate assessed with dynamic HR-US.

We used HR-US to assess 26 patients (age range 34-71) with an orthopaedic diagnosis of plantar plate tear. A Magnetic Resonance imaging (MRi) control was performed in all cases. Moreover, we performed HR-US on 12 healthy volunteers to understand the correct scan technique of the plantar plate and to determine the correct dynamic manoeuvres that allow depicting the normal ultrasound anatomy of this structure

Normal plantar plate is a triangular structure, with homogeneous echogenic appearance; it can be easily assessed with plantar longitudinal scan on the metatarsophalangeal joint (MTPJ) and passive flexion/extension of foot fingers. The dynamic scan allows depicting the relations among the plantar plate and the flexor tendons and the articular cartilage. In our study, HR-US has detected a plantar plate tear in 24/26 patients (16 on MTPJ II, 5 on MTPJ III, 3 both on MTPJ II and III). They appear like small hypoechoic defects of the distal insertional fibres and can be divided into partial (10 patients) and full thickness tears (14 patients). In all patients, MRi confirmed the diagnosis of plantar plate rupture but in nine cases it has not been able to differentiate a partial from a full thickness tear.

HR-US allows to assess the plantar plate in detail and to detect its lesions. In particular, the dynamic analysis is able to differentiate a partial from a full thickness tear.

This is a very useful tool in the dynamic diagnosis of plantar plate tears.

Sconfienza, L, Lacelli, F, Grillo, G, Serafini, G, Garlaschi, G, Silvestri, E, How Dynamic High-resolution Ultrasound (HR-US) Can Improve the Detection of Plantar Plate Tears?.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6022572.html