Male 41 years old with persistent dorsal foot pain in area of 4th metatarsal left foot. No infections signs or symptoms. Markers were placed along the lateral aspect of the foot at the base of the fifth metatarsal and dorsal to the mid diaphysis of the fourth metatarsal. The phalanges and heads of the metatarsals were not included on this study. Based on the markers, we assume the coverage includes the area of patient's pain. If not, the patient may return for additional imaging at no charge.There is deformity of the neck and visualized portions of the head of the fourth metatarsal likely representing old healed fracture but we see no abnormal signal within the visualized portions of the fourth metatarsal. There are small defects in the base of the fourth metatarsal that may represent small cysts or erosions but we see no marrow edema.There is an ossicle proximal to the base of the fifth metatarsal which presumably represents an old ununited fracture fragment as seen on recent radiographs. Small foci of signal abnormality within this ossicle likely represent degenerative changes. There are also small degenerative cysts in the cuboid. Additionally, mild osteoarthritis affects the midfoot and minimal osteoarthritis affects the tibiotalar and subtalar joints. The remaining visualized metatarsals appear normal. The talus, calcaneus and distal tibia/fibula appear normal.There is mild nonspecific subcutaneous edema along the dorsolateral forefoot between the 2 markers and also within the medial and lateral subcutaneous fat of the ankle.There is a longitudinal split tear of the peroneus brevis as it courses posterior to and beneath the fibular tip. The peroneus longus appear slightly thickened suggesting tendinosis. There is fluid within the peroneal tendon sheath indicating tenosynovitis. Remaining tendons appear normal.The anterior talofibular ligament appears slightly thickened which may indicate old injury, but this is equivocal. The remaining ligamentous structures are unremarkable.
1.Markers were placed along the lateral aspect of the foot at the base of the fifth metatarsal and dorsal to the mid diaphysis of the fourth metatarsal. The phalanges and heads of the metatarsals were not included on this study. Based on the markers, we assume the coverage includes the area of patient's pain. If not, the patient may return for additional imaging at no charge.2.Mild osteoarthritis affects the ankle, hindfoot and midfoot.3.Ossicle proximal to the fifth metatarsal base represents an ununited fracture fragment.4.Mild subcutaneous edema in the dorsolateral subcutaneous fat of the forefoot and also within the ankle is nonspecific.5.Longitudinal split tear of the peroneus brevis with peroneal tenosynovitis.