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Dynamic Stress MRI of Midfoot Injuries: Measurable Morphology and Laxity of the Sprained Lisfranc Ligament During Mechanical Loading

A Case Report

Gunio, Drew A. MD, MS1; Vulcano, Ettore MD2; Benitez, Carlos L. MD, MSc1

doi: 10.2106/JBJS.CC.18.00228
Case Reports

Case: Our 26-year-old patient is a professional ballet dancer who suffered a classic Lisfranc joint injury while performing a dancing maneuver with his foot in full plantar flexion. Initial workup with radiographs revealed borderline Lisfranc interval widening without definitive joint instability. Further evaluation with an innovative dynamic stress magnetic resonance imaging (MRI) revealed mild interosseous Lisfranc ligament laxity and sprain, which allowed the orthopaedic surgeon to pursue conservative management, rather than surgery. After physical therapy, our patient reports a successful return to dancing.

Conclusions: Dynamic stress MRI may become a useful technique in evaluating equivocal cases of midfoot injury through the use of new imaging-based criteria.

1Department of Radiology, Mount Sinai West, New York, New York

2Department of Orthopedic Surgery, Mount Sinai West, New York, New York

E-mail address for D.A. Gunio:

Investigation performed at the Department of Radiology, Mount Sinai West, New York, New York

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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