MRI Evaluation of the MTP Plantar Plates Compared With Arthroscopic Findings: A Prospective Study

MRI Evaluation of the MTP Plantar Plates Compared With Arthroscopic Findings: A Prospective Study

Author Nery, Caio Autor UNIFESP Google Scholar
Coughlin, Michael J. Google Scholar
Baumfeld, Daniel Google Scholar
Mann, Tania Szejnfeld Autor UNIFESP Google Scholar
Yamada, Andre Fukunishi Autor UNIFESP Google Scholar
Fernandes, Eloy Avila Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
St Alphonsus Foot & Ankle Clin
Felicio Rocho Hosp
Abstract Background: Instability of the lesser metatarsophalangeal (MTP) joints has been widely reported and plantar plate insufficiency is a key part of this pathologic process. the diagnosis is made clinically but can be aided by imaging studies, particularly magnetic resonance imaging (MRI); however, the sensitivity and accuracy of this method compared to direct visualization of these lesions has not yet been established, nor has interobserver accuracy of MRI been assessed for evaluation of plantar plate pathology. in this study, our goals were to identify the accuracy of the MRI in describing plantar plate tears when compared to direct arthroscopic visualization using an anatomic grading system and to test the influence of an anatomic grading system in the accuracy of the MRI readings.Methods: We evaluated the clinical exam, MRI scans, and arthroscopic findings of 35 patients with lesser MTP instability.Results: Using an anatomic grading system, a distinct improvement in the radiological evaluation and interpretation occurred. Knowledge of the pattern of plantar plate tears by a radiologist enabled them to locate and describe the type of tears of the plantar plate on the MRI. the amount of training and the experience of the radiologist were also important factors in our study. the senior radiologists had much better levels of accuracy (Group A, 77.0%; Group B, 88.5%) than less experienced radiologists.Conclusion: Prior knowledge of the pathophysiology and morphological types of lesions of the plantar plates was helpful for accurate identification and description of the tears by the radiologist.Level of Evidence: Level II, prospective comparative study.
Keywords MRI
MTP plantar plate
arthroscopy
Language English
Date 2013-03-01
Published in Foot & Ankle International. Thousand Oaks: Sage Publications Inc, v. 34, n. 3, p. 315-322, 2013.
ISSN 1071-1007 (Sherpa/Romeo, impact factor)
Publisher Sage Publications Inc
Extent 315-322
Origin http://dx.doi.org/10.1177/1071100712470918
Access rights Closed access
Type Article
Web of Science ID WOS:000330307400001
URI http://repositorio.unifesp.br/handle/11600/36068

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