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MTP Ligament Injury, Digit 1
Corrie M. Yablon, MD; Julia R. Crim, MD; Donna G. Blankenbaker, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Abbreviations

          • Metatarsophalangeal joint (MTPJ)
          • Intersesamoid ligament (ISL)
          • Metatarsosesamoid ligament (MTSL)
          • Sesamoidophalangeal ligament (SPL)
        • Definitions

          • Plantar plate: fibrocartilaginous thickening of plantar joint capsule in which sesamoids are embedded
          • Plantar plate complex: plantar plate, sesamoids, supporting capsule, ligaments, and tendons
          • Extensor expansion: fibrous thickening of dorsal joint capsule, passes around extensor hallucis longus tendon
          • Turf toe: rupture of plantar plate due to hyperdorsiflexion
          • Sand toe: rupture of dorsal joint capsule due to plantar flexion
          • Skimboarder's toe: rupture of dorsal joint capsule due to hyperdorsiflexion
          • Traumatic hallux valgus: rupture of medial collateral ligament (MCL)

        IMAGING

        • General Features

          • Radiographic Findings

            • MR Findings

              • Ultrasonographic Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • Relevant Anatomy

                      CLINICAL ISSUES

                      • Presentation

                        • Natural History & Prognosis

                          • Treatment

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              Selected References

                              1. Hallinan JTPD et al: High-resolution MRI of the first metatarsophalangeal joint: gross anatomy and injury characterization. Radiographics. 40(4):1107-24, 2020
                              2. De Maeseneer M et al: MR imaging-anatomical correlation of the metatarsophalangeal joint of the hallux: ligaments, tendons, and muscles. Eur J Radiol. 106:14-9, 2018
                              3. Nery C et al: MR Imaging of the plantar plate: normal anatomy, turf toe, and other injuries. Magn Reson Imaging Clin N Am. 25(1):127-44, 2017
                              4. Mason LW et al: Turf toe and disorders of the sesamoid complex. Clin Sports Med. 34(4):725-39, 2015
                              5. Linklater JM: Imaging of sports injuries in the foot. AJR Am J Roentgenol. 199(3):500-8, 2012
                              6. Crain JM et al: MR imaging of turf toe. Magn Reson Imaging Clin N Am. 16(1):93-103, vi, 2008
                              7. Donnelly LF et al: Skimboarder's toe: findings on high-field MRI. AJR Am J Roentgenol. 184(5):1481-5, 2005
                              8. Ashman CJ et al: Forefoot pain involving the metatarsal region: differential diagnosis with MR imaging. Radiographics. 21(6):1425-40, 2001
                              9. Watson TS et al: Periarticular injuries to the hallux metatarsophalangeal joint in athletes. Foot Ankle Clin. 5(3):687-713, 2000
                              10. Frey C et al: Plantarflexion injury to the metatarsophalangeal joint ("sand toe"). Foot Ankle Int. 17(9):576-81, 1996
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Imaging

                                  • Top Differential Diagnoses

                                    TERMINOLOGY

                                    • Abbreviations

                                      • Metatarsophalangeal joint (MTPJ)
                                      • Intersesamoid ligament (ISL)
                                      • Metatarsosesamoid ligament (MTSL)
                                      • Sesamoidophalangeal ligament (SPL)
                                    • Definitions

                                      • Plantar plate: fibrocartilaginous thickening of plantar joint capsule in which sesamoids are embedded
                                      • Plantar plate complex: plantar plate, sesamoids, supporting capsule, ligaments, and tendons
                                      • Extensor expansion: fibrous thickening of dorsal joint capsule, passes around extensor hallucis longus tendon
                                      • Turf toe: rupture of plantar plate due to hyperdorsiflexion
                                      • Sand toe: rupture of dorsal joint capsule due to plantar flexion
                                      • Skimboarder's toe: rupture of dorsal joint capsule due to hyperdorsiflexion
                                      • Traumatic hallux valgus: rupture of medial collateral ligament (MCL)

                                    IMAGING

                                    • General Features

                                      • Radiographic Findings

                                        • MR Findings

                                          • Ultrasonographic Findings

                                            • Imaging Recommendations

                                              DIFFERENTIAL DIAGNOSIS

                                                PATHOLOGY

                                                • Relevant Anatomy

                                                  CLINICAL ISSUES

                                                  • Presentation

                                                    • Natural History & Prognosis

                                                      • Treatment

                                                        DIAGNOSTIC CHECKLIST

                                                        • Consider

                                                          Selected References

                                                          1. Hallinan JTPD et al: High-resolution MRI of the first metatarsophalangeal joint: gross anatomy and injury characterization. Radiographics. 40(4):1107-24, 2020
                                                          2. De Maeseneer M et al: MR imaging-anatomical correlation of the metatarsophalangeal joint of the hallux: ligaments, tendons, and muscles. Eur J Radiol. 106:14-9, 2018
                                                          3. Nery C et al: MR Imaging of the plantar plate: normal anatomy, turf toe, and other injuries. Magn Reson Imaging Clin N Am. 25(1):127-44, 2017
                                                          4. Mason LW et al: Turf toe and disorders of the sesamoid complex. Clin Sports Med. 34(4):725-39, 2015
                                                          5. Linklater JM: Imaging of sports injuries in the foot. AJR Am J Roentgenol. 199(3):500-8, 2012
                                                          6. Crain JM et al: MR imaging of turf toe. Magn Reson Imaging Clin N Am. 16(1):93-103, vi, 2008
                                                          7. Donnelly LF et al: Skimboarder's toe: findings on high-field MRI. AJR Am J Roentgenol. 184(5):1481-5, 2005
                                                          8. Ashman CJ et al: Forefoot pain involving the metatarsal region: differential diagnosis with MR imaging. Radiographics. 21(6):1425-40, 2001
                                                          9. Watson TS et al: Periarticular injuries to the hallux metatarsophalangeal joint in athletes. Foot Ankle Clin. 5(3):687-713, 2000
                                                          10. Frey C et al: Plantarflexion injury to the metatarsophalangeal joint ("sand toe"). Foot Ankle Int. 17(9):576-81, 1996