Compiled By: Resham Mendi, M.D.
History:
18-year-old collegiate football player with injury and pain at the ball of the foot when attempting to push off.
Diagnosis:
Turf toe
Findings:
(Fig 1) Sagittal STIR image. There is a small osteochondral injury of the first metatarsal head, with incomplete, full-thickness tear of the plantar capsule. (Fig 2) Sagittal T1-weighted image. Again seen is osteochondral injury of the platar surface of the first metatarsal head with a tear of the plantar capsule.
Discussion:
Turf toe is partial or complete disruption of the plantar plate, resulting from hyperextension at the first metatarsophalangeal (MTP) joint. This typically is seen in football players who play on artificial turf, which is often hard, wearing flexible shoes.
The plantar plate is a stabilizing structure which normally extends from the plantar aspect of the distal metatarsal to the proximal phalanx. With disruption of the plantar plate, MRI may show discontinuity in the structure. High signal is also normally seen in the region of the injury on T2 and STIR images, adjacent to the sesamoid bones. Associated injury to the subchondral bone may be present, as seen in our case.
