Any doctors/podiatrists? Help interpreting MRI results

[garlictwist]

I injured myself iceskating a few weeks ago and the pain has been increasing to the point I can't really walk. I was concerned about a plantar plate tear and ordered an MRI.

These are the results but they don't make sense to me. Can anyone explain? I already knew I have OA in the big toe but the pain I am feeling is my second toe joint and all the MRI seems to talk about is the first - no mention of plantar plate.

Magnetic resonance examination of the left foot shows bone marrow oedema of the plantar aspect of the head of the first metatarsal.

Irregularity of the outline of the medial sesamoid bone is seen. Oedema of the medial sesamoid is also visualised.

There is scarring of the medial collateral ligament of the first MTP joint

Erosions of the margins of the first MTP joint are visualised.

No excessive fluid along the long flexor or extensor tendons.

Oedema of the anterior process of the calcaneum . No fracture line.

Satisfactory alignment at the tarsometatarsal joints.

Signal intensity from the intrinsic foot muscles is normal.

No excessive soft tissue in the web spaces between the metatarsals. Small amount of fluid is visualised in the web space between third and fourth metatarsals.

Conclusions:
Evidence of degenerative oedema at the plantar aspect of the head of the first
metatarsal with medial sesamoiditis. Erosions of the articular surfaces indicating
presence of degenerative arthropathy.
Mild oedema of the anterior process of the calcaneum with no evidence of an
avulsion fracture.

This makes sense to me - I’m a podiatrist. The problem is, a report in isolation isn’t necessarily that helpful. The report + your history + a clinical examination = a better picture of what’s going on.

I’ve not treated many ice skaters with forefoot injuries, but, FWIW, all of them had seaamoid pathology and none had plantar plate injuries.

I’d suggest finding a local podiatrist to get a good plan of attack on your pain.

@Vegemite001 Thank you. I am certainly not an ice skater, I was with the kids and had been wobbling around for 5 minutes when I hurt myself.

So do you think I could still have a tear even though the report doesn't mention it? (appreciate that's hard to answer).

I am going to try get an appointment with a podiatrist too, but thank you for replying.

I think a plantar plate tear is unlikely, though it may well be grumpy. A turf toe injury may give the sesamoid issues you see on the MRI report.

You’re right, it’s hard to say. An MRI sadly doesn’t ping back with a diagnosis, but it can be great at confirming a clinical diagnosis. I personally use an ultrasound scanner in clinic, but again, it’s just to assist the diagnosis.