Aims and objectives
Plantar plate (PP),
also called plantar legament,
is a fibrocartilaginous structure found in the metatarsophalangeal (MP) joint.
PP has its proximal insertion in the metatarsal head and its distal insertion in the base of the proximal phalanx and it blends with the transverse metatarsal ligament at the MP joint.
PP supports the weight of the body and restricts dorsiflexion.
PP disease (PPD) involves the MP joints and brings to instability and pain.
PPD can cause metatarsalgia,
hammertoe deformity and subluxation of the lesser...
Methods and materials
We retrospectively revalued the MRI (S-Scan sectorial MR unit,
Genova-Italy) of 39 patients (12 males,
mean 51,1± 14,6 sd) with diagnosed PPD (complete/partial tear),
performed from June 2015 to September 2015,
by using a standard protocol (T1 and T2 fat suppressed coronal slices,
T2 axial slices and T2 sagittal,
basal and with stress test slices).
PPD was found at second metatarsophalangeal joint (MF) in 3/39 (7,7%),
at second-third MF in 27/39 (69,2%) patients,
at second-third-fourth MF in 9/39 (23,1%).
In 6/39 (15,4%) was observed intermetatarsal space (IS) neuroma,
in 6/39 (15,4%) second IS wide pericapsular fibrosis,
in 6/39 (15,4%) second and third MF bursitis.
In 9/39 (30,8%) were found bone lesions (1/39 second metatarsal Freiberg disease,
1/39 fifth metatarsal head stress fracture,
7/39 first MF degenerative arthritis) and in 12/39 (30,8%) flexor tendinopathy.
In our study PPD is frequently associated (27/39,
69,2%) with other forefoot diseases,
all reliably related to microtraumatic chronic pathogenesis and therefore may be thought as a part of a chronic overload syndrome; in particular the frequence of bone involvement (30,8%) necessarily requires MRI evaluation in order to perform an exhaustive early diagnosis.
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