SYMPTOMS:
Patient experienced a chronic pain and aching in the left forefoot. After physical examination, X-rays were obtained. The podiatrist referred the patient for high resolution 3T MRI utilizing a dedicated 8-channel foot and ankle “ski-boot coil”. The specialty imaging coil for the 3T MRI scanner aided in generating much higher resolution MRI images than can be obtained with traditional open architecture or 1.5T equipment. Extremely high resolution images were obtained aiding the radiologist and referring physician in identifying multiple subtle pathologies including a somewhat rare finding of “Morton’s Neuroma”.
SUMMARY OF FINDINGS:
1. Enhancing 5 mm soft tissue density between the plantar aspect of the third and fourth metatarsal heads, consistent with a small Morton’s neuroma.
2. Nonspecific synovitis at the third through fifth tarsometatarsal joints and at the third metatarsophalangeal joint.
3. Developing second and third claw toes.
4. Mild first metatarsophalangeal and sesamoid-first metatarsophalangeal osteoarthrosis, and mechanical erosions between the second and third metatarsal heads.