EURORAD ESR

Case 9764

Case of a painful toe

Author(s)
Sangeetha Govinda Rajoo1, Sivadas Ganeshalingham2

(1) E-Learning Fellow, Barts & The London School of Medicine, Queen Mary University of London, Whitechapel.
(2) Consultant Radiologist, Barts & The London NHS Trust, Whitechapel.

Barts & The London NHS Trust,
Queen Mary University of London,
Centre of Medical Education; Room 3.10,
Garrod Building, Turner Street
E1 2AD London;
Email:sgrajoo@doctors.org.uk
 
Patient
male, 39 year(s)
 
 
  • Figure 1
    Plain radiograph of left foot
     

    This demonstrates a bipartite medial sesamoid

     
    Area of Interest: Anatomy; Musculoskeletal bone; Musculoskeletal soft tissue; Imaging Technique: Plain radiographic studies; Procedure: Education; Special Focus: Infection;

    Enlarged radiograph of the sesamoid bones and first metatarsal.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: Plain radiographic studies; Procedure: Education; Special Focus: Infection;
     
     
  • Figure 2
    MR (Short axis T1 weighted sequence)

    This demonstrates T1 hypointensity within the medial sesamoid.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Infection;
     
     
  • Figure 3
    MR (Short axis T2 FS sequence)

    This demonstrates high signal within the medial sesamoid and high signal within the adjacent subcutaneous fascia with fluid within the flexor tendon sheath.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Infection;
     
     
  • Figure 4
    MR (Post-contrast T1 FS sequence in the short axis)

    There is enhancement of the medial sesamoid as well as within the adjacent soft tissues. No discrete collection.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Infection;
     
     
This demonstrates a bipartite medial sesamoid
 
Enlarged radiograph of the sesamoid bones and first metatarsal.
 
This demonstrates T1 hypointensity within the medial sesamoid.
 
This demonstrates high signal within the medial sesamoid and high signal within the adjacent subcutaneous fascia with fluid within the flexor tendon sheath.
 
There is enhancement of the medial sesamoid as well as within the adjacent soft tissues. No discrete collection.
 
 
 
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