Diego Avila Lessa Garcia MD, Presenter: Nothing to Disclose

Higor Grando MD, Abstract Co-Author: Nothing to Disclose

Eric Y. Chang MD, Abstract Co-Author: Nothing to Disclose

Sheronda Statum, Abstract Co-Author: Nothing to Disclose

Graeme M. Bydder MBChB, Abstract Co-Author: Nothing to Disclose

Christine B. Chung MD, Abstract Co-Author: Nothing to Disclose

There is discrepancy regarding the nomenclature and inconsistent anatomical descriptions in the literature with regard to the plantar plate of the first metatarsophalangeal joint (MTPJ). The purpose of the study is 1) to provide high and ultra-high resolution morphologic evaluation of the plantar region of the first MTPJ focusing on anatomic relationships and structural integrity and 2) to introduce the concept of the plantar plate complex.

The first MTPJ of six fresh-frozen cadavers were used for this study. Imaging of the first MTPJ was performed on a 3.0T clinical MR system (General Electric Healthcare Medical Systems, Milwaukee, WI, United States) with a 2D intermediate-weighted sequence (TR 2000ms TE 35ms) and a 3D-FSPGR sequence (TR 50ms TE 5.2ms) as well as on an 11.7T MR system with a spin echo sequence (TR 5000ms TE 10ms). The plantar regions of each MTPJ were qualitatively analyzed on the MR images. Correlation with gross anatomic dissections and histology was performed.

Five ligaments, two sesamoids, a fibrous tissue pad, a capsule and six tendons compose the plantar plate region of the first MTPJ. The external and internal architecture of each of these structures is well demonstrated at both field strengths. Through anatomic and histologic correlation, it is evident that the first plantar plate is not a single structure, but rather a capsuloligamentous complex assisted by a dynamic musculotendinous apparatus.

MR imaging with gross and histologic correlation allows clarification of the previously confusing plantar plate complex of the first MTPJ.

Dedicated coils and high resolution MRI allows for evaluation of the first MTPJ at a level never before seen. Knowledge of the normal detailed anatomy of each component is important for radiological interpretation.

Garcia, D, Grando, H, Chang, E, Statum, S, Bydder, G, Chung, C, The Plantar Plate Complex of the First Metatarsophalangeal Joint: High Resolution MR Imaging at 11.7T and 3.0T with Anatomic and Histologic Correlation.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012324.html