Understanding Lisfranc Injuries: Seeking Guidance
Hello, I need some help regarding an injury to my foot. I participate in tackle football and sustained an injury during a collision in a game. When I landed, I struck the ball of my foot with my toes curled under. I felt a significant tear at the top of my foot, and soon after, swelling occurred inside my cleat when I attempted to put weight on it. I underwent both an X-ray and a CT scan, which came back negative. Last week, I had an MRI, and my doctor has recommended that I consult a podiatrist. I have attached my MRI findings for reference. This incident took place around a month ago, and I have been using a medical boot since then. I can manage to walk in the boot now, but I cannot apply weight to the middle of my foot or walk normally due to sharp, nerve-like pain radiating through the sole. Additionally, I experience discomfort in my midfoot area. My second and third toes remain tightly pressed together and won't separate at all, even when I try to spread them using my foot muscles. I am looking for recommendations on what my injury might be, whether seeing a podiatrist is the appropriate next step, or if I should insist on an appointment with an orthopedic surgeon. Here are the MRI findings: - **MRI Left Foot** - **Comparison:** None - **Technique:** Multiplanar, multi-sequence MRI of the foot was conducted. - **Findings:** There are signs of bone marrow edema likely showing a contusion at the lateral cuneiform and base of the second metatarsal. Soft tissue edema has been detected in the area around the tarsometatarsal joints, including the Lisfranc ligament, but no complete tear of the ligament was observed. The alignment of the Lisfranc joint is intact. Also noted is focal plantar soft tissue edema involving the peroneal longus tendon where it attaches at the base of the first metatarsal. There are no tears evident in either ligaments or tendons. - **Impression:** 1. Bone marrow edema at the lateral cuneiform and base of the second metatarsal. 2. Presence of soft tissue edema in the area near the Lisfranc ligament without complete tearing of the ligament. 3. Focal plantar soft tissue edema with signs of tendinosis in the peroneal longus tendon. I would be grateful for any advice you could provide!
Answers (1)
6/27/2025, 12:10:52 AM
OpenHealth AI
It sounds like you've experienced a significant foot injury with concerning symptoms, and I recognize how frustrating and painful this situation can be for you. Your MRI findings suggest there is some damage but not a complete tear of the Lisfranc ligament, which is a positive indication that may guide your recovery plan.
Main Points:
- Current Injury Understanding: You have signs of bone marrow edema and soft tissue swelling, indicating trauma but no major ligament tears, which is a good sign.
- Next Steps: Consulting with a podiatrist is a good decision; they are specialists in foot injuries and can guide your rehabilitation effectively.
Explanation:
The Lisfranc injury is a complex issue involving the bones and ligaments in the midfoot. The fact that your MRI did not reveal complete tears is reassuring, but the swelling and pain you're experiencing indicate that you need to be careful with how you manage this injury. Bone marrow edema usually signifies that there’s been some trauma or strain, and soft tissue edema around the Lisfranc area suggests that while there isn’t a complete injury, there is still significant damage that needs to heal.
Your inability to separate your toes and the sharp nerve-like pain are also symptoms that warrant thorough evaluation and proper rehabilitation.
Next Steps:
- Follow Up with Your Podiatrist: Schedule an appointment promptly. A podiatrist can assess the finer details of your injury and develop a tailored treatment plan.
- Limit Weight Bearing: Continue to use the medical boot for the time being. Avoid placing weight on your foot when possible to prevent further injury.
- Pain Management: Use over-the-counter pain relief, like ibuprofen or acetaminophen, as needed, following the recommended dosages. This can help manage inflammation and pain.
- Gentle Stretching and Movement: Once you’re evaluated by the podiatrist, start with gentle stretching of your toes and foot as recommended. Don't force movement, especially with the toes that are not separating easily.
- Monitor Symptoms: Keep track of any changes in pain, swelling, or mobility. If your symptoms worsen, such as increased pain or difficulty walking, notify your healthcare provider.
You’re on the right path by seeking further expertise and prioritizing your foot care. It’s important to give your injury time to heal properly to avoid complications in the future. Let me know if you have any further questions or concerns!
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